Sex Differences in Parkinson’s Disease Caregiving (S48.003)

OBJECTIVE: To investigate caregiving patterns among Parkinson’s disease (PD) patients and determine if there are sex differences in caregiver accompaniment to visits, paid caregiving and caregiving strain. BACKGROUND: As PD-related disability worsens, patients often rely on both formal and informal caregiver support. Researchers report sex-related differences in PD epidemiology, including higher incidence among men and numerous differences in disease phenotype. However, little is known about caregiving patterns by sex. DESIGN/METHODS: We studied PD subjects enrolled in the National Parkinson Foundation Parkinson’s Outcomes Project (annual registry from 21 international Movement Disorders Centers). We collected medications, disease duration, Hoehn and Yahr staging, cognitive function, timed-up-and-go and PDQ-39. Caregiver-related measures included presence and type of caregiver, time to first paid caregiver and Multi-dimensional Caregiver Strain Index (MCSI). Using backward selection for inclusion of covariates, several regression models were run: 1) Logistic regression of caregiver accompaniment at baseline; 2) Linear regression of MCSI; and 3) Cox regression of time to first paid caregiver. RESULTS: 4718 men and 2788 women participated. Compared with women, men were significantly more likely to have a regular care partner (88.3[percnt] vs. 80.1[percnt], p<0.001), but less likely to have a paid caregiver at baseline (2.2[percnt] vs. 4.9[percnt], p<0.001). Adjusting for demographics and disease severity measures, women had lower odds of caregiver accompaniment to baseline visit (OR 0.74, 95[percnt]CI 0.65-0.84, p<0.001) but faster time to first paid caregiver (HR 1.52, 95[percnt]CI 1.20-1.92, p=0.002). Strain was higher among caregivers of male subjects (20.2 vs. 16.9, p<0.001) and after adjustment for potential confounders, male sex remained associated with higher strain (p<0.001). CONCLUSIONS: Women with PD have fewer informal caregiving resources and are more likely to use formal, paid caregiving. Stakeholders in PD care should develop policies to ensure adequate support for women with PD. Study Supported by: National Parkinson Foundation Disclosure: Dr. Shah has nothing to disclose. Dr. Qinglin has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Schmidt has nothing to disclose. Dr. Cubillos has nothing to disclose. Dr. Dahodwala has received research support from Teva.