比較年輕型及老年型失智症個案家庭照顧需求及主要照顧者負荷

Young-Onset and Late-Onset Dementia Cases: A Comparison of Family Care Needs and Primary Caregiver Burden

背景：年輕型失智症（65歲前發病）症狀多樣且不易診斷，確診後常面臨提早退休、財務影響等，照顧者將產生沉重負荷，雖然已有研究指出年輕型與老年型失智症在照顧負荷及照顧需求上之差異，但多為兩者分開比較，而國內同時納入年輕型及老年型失智症家庭照顧需求及照顧者負荷比較之研究甚少，亦為研究之缺口。
目的：比較年輕型及老年型失智症個案家庭照顧需求及主要照顧者負荷。
方法：採橫斷式調查法，以方便取樣方式，依「個案發病時年齡」分為年輕型（< 65歲）及老年型（≥65歲），採自填式問卷進行一次性資料收集，評量工具包含家屬及個案基本資料表、Zarit負荷量表、失智症家庭照護需求評估表。
結果：本研究共105位失智症主要照顧者參與，年輕型失智症家庭在五項照顧需求次量表（包含語言及溝通、日常生活功能、行為精神症狀、照顧者壓力、資源及協助）、照顧需求總分及照顧者負荷總分皆顯著高於老年型，進一步分析中，顯示年輕型個案之「行為精神症狀」需求與老年型個案之「語言與溝通、日常生活功能」需求，與照顧者負荷達顯著正相關；此外，年輕型失智個案之年齡，與照顧者負荷達顯著負相關。
結論／實務應用：年輕型失智症個案之家庭照顧需求、照顧者負荷，均顯著高於老年型。建議長照服務能夠擴大納入50歲以下未領有身心障礙證明之失智症個案，並針對不同需求規劃個別性服務並教導常見照護技巧，以減輕照顧者負荷。

Background: Young-onset dementia, defined as dementia diagnosed before the age of 65, is characterized by diverse symptoms and a high likelihood of misdiagnosis. Individuals diagnosed with young-onset dementia often face challenges such as early retirement and financial strain, leading to a significant burden for primary caregivers. Although previous studies have documented differences in caregiver burden and family care needs between patients with young-onset and late-onset dementia, few have analyzed both groups concurrently. Similar the state of international research, few studies have examined these aspects concurrently in Taiwan.
Purpose: This study was designed to compare the family care needs and caregiver burdens associated with patients with young-onset and late-onset dementia.
Methods: This cross-sectional study employed convenience sampling. The participants were categorized into young-onset (less than 65 years old) and late-onset (65 years old or older) caregiver groups. Study data were collected using a self-administered questionnaire that included a primary caregiver and patient characteristics datasheet, the Zarit Burden Interview measure, and the Assessment Tool for Family Care Needs of Dementia.
Results: One hundred and five primary caregivers of dementia patients were enrolled as participants. Total care needs, the five care-need subscales (i.e., language and communication, activities of daily living, behavioral and psychological symptoms, care stress, and obtaining resources), and caregiver burden levels were found to be significantly higher in the young-onset group than the late-onset group. Further analysis revealed significantly positive correlations between both behavioral and psychological symptoms and caregiver burden in the young-onset dementia group. Conversely, in the late-onset dementia group, caregiver burden was found to be significantly associated with language, communication, and activities of daily living. Furthermore, age in young-onset dementia patients was found to correlate significantly and negatively with caregiver burden.
Conclusion / Implications for Practice: Significant differences in family care needs and primary caregiver burden were found between the young-onset and late-onset dementia groups, with the former associated with greater caregiving needs and burdens. Long-term care services should be extended to patients with dementia who do not have an officially recognized disability certificate and below the age of 50. These services should be tailored to meet individual needs, equip caregivers with essential caregiving skills, and provide targeted support.