The association between cognitive abnormality of elderly patients and caregiver anxiety and depression symptom scores among Chinese caregivers in a general out-patient clinic in Hong Kong

Ho Ming LEE(Po Ning Road Family Medicine Center)

Abstract

Objective: This study aims to determine the proportion of elderly patients aged ≥70 years with cognitive abnormality [defined as Abbreviated Mental Test (AMT) score <6], and to compare anxiety and depression symptom scores between Chinese caregivers of elderly patients with AMT score <6 and those of elderly patients with AMT score ≥6 in a general out-patient clinic in Hong Kong.

Methods: A total of 340 elderly patients aged ≥70 years old were recruited in a public general out-patient clinic in Hong Kong. AMT was administered to them by one doctor during consultation. One hundred caregivers were given the General Anxiety Disorder-7 and Patient Health Questionnaire-9 (GAD-7-PHQ-9) questionnaires. GAD-7 and PHQ-9 scores were tested for normality using normal probability plots, the Shapiro-Wilk and Kolmogorov-Smirnov normality tests. Wilcoxon Rank Sum test was used for non-normal data distribution. Confounding factors for caregiver stress were identified by literature review. Multiple linear regression was used to model the association between the covariates and the anxiety and depression scores.

Results: The proportion of patients having AMT score <6 was 26.2% (95% CI 21.58-31.19%). The median GAD-7 scores of caregivers were 7 (IQR: 3-14) and 3 (IQR: 1-6) for elderly patients with AMT<6 and ≥6 respectively. The median PHQ-9 scores of caregivers were 7 (IQR: 3-14) and 2 (IQR: 1-4) for elderly patients with AMT score <6 and ≥6 respectively. Both scores were significantly different between the two groups of caregivers (Wilcoxon Rank Sum test, p-values<0.001).

Conclusion: The proportion of patients with cognitive impairment was 26.2% (defined as AMT score <6) among 340 patients aged ≥70 in our clinic. Caregivers of elderly patients with AMT < 6 had significantly higher anxiety and depression scores than those of elderly patients with AMT ≥6. Family doctors should strengthen support to caregivers of elderly patients with cognitive abnormality.

Keywords

caregiver anxiety, caregiver depression, cognitive abnormality, elderly, Chinese

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DOI: http://dx.doi.org/10.26549/jams.v9i1.37884