Quality of life of caregivers of people with Alzheimer΄s disease in Greece
DOUDOUMI S., TSOLAKI M., SAGIADINOU M.M., DEOUDI P., KIOSSEOGLOU G., KAZIS A.
3rd Department of Neurology and Department of Psychology, Aristotle University of Thessaloniki, Greece

Alzheimer's disease attacks one of the human functions: it progressively destroys the brain neurons. Although Dementia initially attacks mental functions, there are also many changes in the patient's personality, who becomes strange and odd. The difficulties that the family caregivers come up against -caused by the changes in the patient's personality- create more problems in comparison to the losses in the mental sphere.

The general hypothesis is that taking care of people with Alzheimer's disease, or Dementia, is negatively related to the Quality of Caregivers' life, and more spesifically, to disposition, life conditions, friendships, and ability to enjoy themselves.

This has been a brief overview of the literature on family caregivers (spouses, children, relatives) of people with Alzheimer's disease and the way caregiving affects their everyday lives. The aim of the present study is to examine the quality of life in caregivers of patients with Alzheimer's disease, in comparison to the quality of life of an age-matched control group. The sample of this research consisted of 62 participants, of whom 31 were caregivers and 31 constituted the control group. The first group comprised caregivers who accompanied Alzheimer's disease patients to the 3rd Department of University Neurological Clinic of the “G. Papanikolaou” hospital. The control group comprised 31 citizens of Xanthi, who were not caregivers. The Questionnaire Quality of life in Alzheimer's disease: Patient and caregiver report (QOL-AD), (Logsdon RG, Gibbons LE, McCurry SM, Terill (1998), University of Washington) was applied in the form of an interview with people with Dementia. It is addressed both to Alzheimer's disease patients and to their caregivers. It examines how they feel in the present time in 13 aspects of their lives: physical well-being, energy, disposition, life conditions, memory, family, marriage, friendships, self, ability to do the housework, ability to entertain themselves, financial state and outlook on their lives. Each of the above apects corresponds to a question. The 13 questions are marked on a four-point scale, in which 1 corresponds to a performance, while 4 corresponds to the best attribution, with a general score between 13 and 52. In order to calculate the final score the patients' and caregivers' scores are summed. The internal reliability of the scale was good enough (Cronbach's alpha = 0.88).

After conducting principal component analysis with varimax rotation on the 13 questions of the Quality of Life questionnaire, 4 factors emerged which examined selected aspects of the quality of life and explained the 66,35% of the total variance.

The first one is the General factor, which includes the questions that are related to the disposition, memory, self, and ability to entertain themselves. the second is the Socio-economic factor, which includes the questions related to life situations, friendships, financial state and general outlook on life. The third is the Physical well-being/Vigour factor that comprises the questions related to physical well-being, energy and ability to perform housework. Finally the fourth is the Family factor and comprises questions related to family and marriage.

The method of T-test for inderendent samples was used to examine whether there was a significant difference between the two groups regarding the four factors of the QOL-AD questionnaire. We found significant differences in favour of the control group concerning the General factor (t(60)=2.72, p=.009) as well as the Socioeconomic factor (t(59)=4.06, p=.000). On the contrary, no significant results were found concerning the factorPhysical well-being/Vigour (t(60)=.96, p>.05) and the factor Family (t(49=.11, p>05).

The results of the comparisonbetween the quality of life of caregivers of patients with Alzheimer's disease and the quality of the participants in the control group were predictable. In general the caregivers' group seems to have a much poorer quality of life than the control group. More spesifically, a significant difference was found between the two groups both in General factor as well as in the Socioeconomic factor, a fact that sustains our prior hypothesis that the caring of patients with Alzheimer's disease has a negative effect on the caregivers' quality of life. In particular, there is a stronger correlation in the Socioeconomic factor. This results from the fact that the Alzheimer's disease creates great financial burden.

Conclusively, the quality of life of caregivers of pateints with Alzheimer's Disease is very low and they require help in order to fulfill their difficult caring task. In Greece, the Hellenic Alzheimer's Disease and Related Disorders Association tries to assist caregivers via support groups and personal psychotherapy. We try to create branches all over Greece so that every caregiver has the opportunity to take part in such groups.

Key words: Quality of life, Caregivers, Alzheimer's Disease.