Assessment of the impact of MoCA-Ina (Montreal Cognitive Assessment Indonesia version) scores on depression, burden, and knowledge in dementia caregivers

Authors

  • Pinasti Utami Doctoral Graduate Programme, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia & Department of Pharmacology and Clinical Pharmacy, Faculty of Medical and Health Science, Muhammadiyah University of Yogyakarta
  • Zullies Ikawati Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia
  • Fita Rahmawati Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia
  • Astuti Department of Neurology, Faculty of Medicine, Gadjah Mada University, Dr. Sardjito Hospital, Yogyakarta

DOI:

https://doi.org/10.46542/pe.2024.249.3239

Keywords:

Dementia assessment scale, Dementia caregiver, Montreal cognitive assessment-Indonesia, Hamilton depression scale, Zarit burden interview

Abstract

Background: Dementia patients necessitate intensive care, often imposing a substantial burden on caregivers. With the rising global prevalence of dementia, it becomes crucial to elucidate the determinants that influence caregiver stress and overall well-being.

Objective: This research mainly aimed to examine the impact of the Montreal Cognitive Assessment Ver. Indonesia (MoCA-Ina) score on the stress scale, life burden, and knowledge level among caregivers of dementia patients.

Method: Observational research was conducted at Dr Sardjito Hospital Yogyakarta's Memory Clinic between March and May 2023. The study involved dementia patients who met specific criteria. Caregivers completed questionnaires, including the Hamilton Depression Rating Scale (HDRS), Zarit Burden Interview (ZBI), and Dementia Knowledge Assessment Scale (DKAS). The data was analysed using the Spearman correlation test.

Result: The research findings from 47 participants showed that the majority of caregivers were male (55.3%), university-educated (38.3%), family members (42.5%), spent over six hours per day with the patient (63.8%), and cared for the patient for varying durations. Caregiver stress scale scores indicated mild depression, mild-moderate burden, good knowledge level, and severe cognitive impairment. The Spearman test found no significant correlation between the cognitive impairment score and caregiver stress, burden, or knowledge level.

Conclusion: MoCA-INA score in patients with dementia did not affect the caregiver's stress scale, caregiver burden, or knowledge levels.

References

Adana, F., Ozvurmaz, S., & Mandiracioglu, A. (2022). Burden on caregivers of dementia patients and affecting factors in Turkey: A Systematic Review. JPMA. The Journal of the Pakistan Medical Association, 72(1), 108–114. https://doi.org/10.47391/JPMA.2168

Afriyeni, N., & Sartana, S. (2016). Gambaran tekanan (strain) dan beban (burden) pada caregiver penderita spikotik di RSU PROF.H.B.SA’ANIN PADANG. Jurnal Ecopsy, 3(3), 115–120.

Aisy Sunaryo, S. R., Saifullah, A. D., & Mulyani, S. (2020). Knowledge and attitudes toward people with dementia among nursing students in Yogyakarta, Indonesia. Belitung Nursing Journal, 6(6), 196–202. https://doi.org/10.33546/BNJ.1178

Alzheimer’s Disease International. (2018). World Alzheimer Report 2018: The state of the art of dementia research: New frontiers. https://www.alzint.org/resource/world-alzheimer-report-2018/

Annear, M. J., Toye, C. M., Eccleston, C. E., McInerney, F. J., Elliott, K. E. J., Tranter, B. K., Hartley, T., & Robinson, A. L. (2015). Dementia knowledge assessment scale: Development and preliminary psychometric properties. Journal of the American Geriatrics Society, 63(11), 2375–2381. https://doi.org/10.1111/JGS.13707

Bayati, T., Dehghan, A., Bonyadi, F., & Bazrafkan, L. (2018). Investigating the effect of education on health literacy and its relation to health-promoting behaviors in health center. Journal of Education and Health Promotion, 7(1), 127. https://doi.org/10.4103/JEHP.JEHP_65_18

Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014

Bednarek, A., Mojs, E., Krawczyk-Wasielewska, A., Głodowska, K., Samborski, W., Lisiński, P., Kopczyński, P., Gregersen, R., & Millán-Calenti, J. C. (2016). Correlation between depression and burden observed in informal caregivers of people suffering from dementia with time spent on caregiving and dementia severity. Eur Rev Med Pharmacol Sci, 20(1), 59–63.

Besser, L. M., & Galvin, J. E. (2019). Perceived burden among caregivers of patients with frontotemporal degeneration in the United States. International Psychogeriatrics, 31(8), 1191–1201. https://doi.org/10.1017/S104161021800159X

Central Bureau of Statistics. (2021). Elderly population statistics in 2020. https://www.bps.go.id/en/publication/2020/12/21/0fc023221965624a644c1111/statistics-of-aging-population-2020.htmlv

Chen, C., Homma, A., Mok, V. C. T., Krishnamoorthy, E., Alladi, S., Meguro, K., Abe, K., Dominguez, J., Marasigan, S., Kandiah, N., Kim, S. Y., Lee, D. Y., De Silva, H. A., Yang, Y. H., Pai, M. C., Senanarong, V., & Dash, A. (2016). Alzheimer’s disease with cerebrovascular disease: current status in the Asia–Pacific region. Journal of Internal Medicine, 280(4), 359–374. https://doi.org/10.1111/joim.12495

Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., & Yaffe, K. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18(12), 1006–1014. https://doi.org/10.1111/J.1525-1497.2003.30103.X

De Vugt, M. E., Stevens, F., Aalten, P., Lousberg, R., Jaspers, N., & Verhey, F. R. J. (2005). A prospective study of the effects of behavioral symptoms on the institutionalization of patients with dementia. International Psychogeriatrics, 17(4), 577–589. https://doi.org/10.1017/S1041610205002292

Deskianditya, R. B., Astuti, A., & Yudiyanta, Y. (2021). Caregiver’s burden and age are related determinants to quality of life in people with dementia. Journal of Community Empowerment for Health, 4(2), 94. https://doi.org/10.22146/JCOEMPH.60432

Galvin, J. E., Valois, L., & Zweig, Y. (2014). Collaborative transdisciplinary team approach for dementia care. Neurodegenerative Disease Management, 4(6), 455–469. https://doi.org/10.2217/nmt.14.47

Husein, N., Lumempouw, S. F., & Ramli, Y. (2010). Montreal Cognitive Assessment Indonesian version MoCAIna for screening impaired cognitive function. Neurona. https://scholar.ui.ac.id/en/publications/montreal-cognitive-assessment-versi-indonesia-mocaina-untuk-skrin

Ku, L. J. E., Chang, S. M., Pai, M. C., & Hsieh, H. M. (2019). Predictors of caregiver burden and care costs for older persons with dementia in Taiwan. International Psychogeriatrics, 31(6), 885–894. https://doi.org/10.1017/S1041610218001382

Liang, X., Guo, Q., Luo, J., Li, F., Ding, D., Zhao, Q., & Hong, Z. (2016). Anxiety and depression symptoms among caregivers of care-recipients with subjective cognitive decline and cognitive impairment. BMC Neurology, 16(1). https://doi.org/10.1186/S12883-016-0712-2

Liu, S., Li, C., Shi, Z., Wang, X., Zhou, Y., Liu, S., Liu, J., Yu, T., & Ji, Y. (2017). Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer’s disease caregivers in China. Journal of Clinical Nursing, 26(9–10), 1291–1300. https://doi.org/10.1111/JOCN.13601

Lou, Q., Liu, S., Huo, Y. R., Liu, M., Liu, S., & Ji, Y. (2015). Comprehensive analysis of patient and caregiver predictors for caregiver burden, anxiety and depression in Alzheimer’s disease. Journal of Clinical Nursing, 24(17–18), 2668–2678. https://doi.org/10.1111/JOCN.12870

Lucijanić, J., Baždarić, K., Librenjak, D., Lucijanić, M., Hanževački, M., & Jureša, V. (2020). A validation of the Croatian version of Zarit Burden Interview and clinical predictors of caregiver burden in informal caregivers of patients with dementia: a cross-sectional study. Croatian Medical Journal, 61(6), 527–537. https://doi.org/10.3325/CMJ.2020.61.527

Mokuau, N., & Tomioka, M. (2010). Caregiving and older Japanese adults: Lessons learned from the periodical literature. Journal of Gerontological Social Work, 53(2), 117–136. https://doi.org/10.1080/01634370903202868

Mould-Quevedo, J. F., Tang, B., Harary, E., Kurzman, R., Pan, S., Yang, J., & Qiao, J. (2013). The burden of caring for dementia patients: Caregiver reports from a cross-sectional hospital-based study in China. Expert Review of Pharmacoeconomics & Outcomes Research, 13(5), 663–673. https://doi.org/10.1586/14737167.2013.838029

O’Caoimh, R., Calnan, M., Dhar, A., & Molloy, D. W. (2021). Prevalence and predictors of caregiver burden in a memory clinic population. Journal of Alzheimer’s Disease Reports, 5(1), 739. https://doi.org/10.3233/ADR-201003

Ohno, S., Chen, Y., Sakamaki, H., Matsumaru, N., Yoshino, M., & Tsukamoto, K. (2021). Burden of caring for Alzheimer’s disease or dementia patients in Japan, the US, and EU: results from the National Health and Wellness Survey: A cross-sectional survey. Journal of Medical Economics, 24(1), 266–278. https://doi.org/10.1080/13696998.2021.1880801

Perdossi. (2015). Clinical practice guideline for the diagnosis and management of dementia. https://medstellar.blogspot.com/2018/09/panduan-praktik-klinik-diagnosis-dan.html

Perrar, K. M., Schmidt, H., Eisenmann, Y., Cremer, B., & Voltz, R. (2015). Needs of people with severe dementia at the end-of-life: A systematic review. Journal of Alzheimer’s Disease, 43(2), 397–413. https://doi.org/10.3233/JAD-140435

Putri, Y. S. E., Putra, I. G. N. E., Falahaini, A., & Wardani, I. Y. (2022). Factors associated with caregiver burden in caregivers of older patients with dementia in Indonesia. International Journal of Environmental Research and Public Health, 19(19), 12437. https://doi.org/10.3390/IJERPH191912437

Putri, Y. S. E., & Riasmini, N. M. (2013). The predictors of caregiver burden and depression level in caring elderly people with dementia at community. Jurnal Ners, 8(1), 88–97. https://www.neliti.com/id/publications/120318/

Razi, N. A. M., Minhat, H. S., Zulkefli, N. A. M., Ahmad, N., Mohd, T. A. M. T., & Jaafar, H. (2023). A systematic review on caregiver’s burden among caregivers of dementia patients in Malaysia. Malaysian Journal of Medicine and Health Sciences.

Shim, Y. S., Park, K. H., Chen, C., Dominguez, J. C., Kang, K., Kim, H. J., Hong, Z., Lin, Y. Te, Chu, L. W., Jung, S., & Kim, S. Y. (2021). Caregiving, care burden and awareness of caregivers and patients with dementia in Asian locations: a secondary analysis. BMC Geriatrics, 21(1), 1–10. https://doi.org/10.1186/S12877-021-02178-X/TABLES/5

Suriastini, N. W., Turana, Y., Supraptilah, B., Wicaksono, T. Y., & Mulyanto, E. D. (2020). Prevalence and risk factors of dementia and caregiver’s knowledge of the early symptoms of alzheimer’s disease. Aging Medicine and Healthcare, 11(2), 60–66. https://doi.org/10.33879/AMH.2020.065-1811.032

Suriastini, Turana, Y., Witoelar, F., Supraptilah, B., Wicaksono, T. Y., & Dwi, E. (2016). Dementia prevalence rate, needs our attention. Pancanaka, 1(2), 14.

Sutcliffe, C., Giebel, C., Bleijlevens, M., Lethin, C., Stolt, M., Saks, K., Soto, M. E., Meyer, G., Zabalegui, A., Chester, H., Challis, D., Meyer, G., Stephan, A., Renom-Guiteras, A., Sauerland, D., Wübker, A., Bremer, P., Hamers, J. P. H., Afram, B., … Vellas, B. (2017). Caring for a person with dementia on the margins of long-term care: A perspective on burden from 8 European countries. Journal of the American Medical Directors Association, 18(11), 967-973.e1. https://doi.org/10.1016/J.JAMDA.2017.06.004

Triyono, H. G., Dwidiyanti, M., & Widyastuti, R. H. (2018). The differences in the level of caregiver burden caring for elderly dementia in nursing homes. Holistic Nursing and Health Science, 1(2), 77. https://doi.org/10.14710/hnhs.1.2.2018.77-81

Tsai, C. F., Hwang, W. S., Lee, J. J., Wang, W. F., Huang, L. C., Huang, L. K., Lee, W. J., Sung, P. S., Liu, Y. C., Hsu, C. C., & Fuh, J. L. (2021). Predictors of caregiver burden in aged caregivers of demented older patients. BMC Geriatrics, 21(1), 1–9. https://doi.org/10.1186/S12877-021-02007-1/TABLES/3

Wang, J., Xiao, L. D., He, G. P., Ullah, S., & De Bellis, A. (2014). Factors contributing to caregiver burden in dementia in a country without formal caregiver support. Aging & Mental Health, 18(8), 986–996. https://doi.org/10.1080/13607863.2014.899976

World Health Organization (WHO). (2021). Be He@lthy, Be Mobile. A handbook on how to implement mDementia. World Health Organization and International Telecommunication Union. https://www.who.int/publications/i/item/9789240019966

Zhang, Y. H., Cheng, Y., Wang, Z., Yang, T., Lv, W., & Huang, H. (2021). Factors influencing depression in primary caregivers of patients with dementia in China: A cross-sectional study. Geriatric Nursing (New York, N.Y.), 42(3), 734–739. https://doi.org/10.1016/J.GERINURSE.2021.03.017

Zimmerman, M., Martinez, J. H., Young, D., Chelminski, I., & Dalrymple, K. (2013). Severity classification on the Hamilton depression rating scale. Journal of Affective Disorders, 150(2), 384–388. https://doi.org/10.1016/j.jad.2013.04.028

Downloads

Published

23-12-2024

How to Cite

Utami, P., Ikawati, Z., Rahmawati, F., & Astuti. (2024). Assessment of the impact of MoCA-Ina (Montreal Cognitive Assessment Indonesia version) scores on depression, burden, and knowledge in dementia caregivers. Pharmacy Education, 24(9), p. 32–39. https://doi.org/10.46542/pe.2024.249.3239

Issue

Section

Special Edition