Perspektif Tingkat Kemampuan dan Transformasi Wirausahawan Merubah Risiko menjadi Sukses Berwirausaha

Abstract

Objective: The aim of this study is to describe the differences among elderly multiple sclerosis patients with and without an informal caregiver regarding quality of life, neuropsychological impairment, cognition, and severity of depression. Background MS is a progressive neurological illness generally beginning as relapsing/remitting, later becoming secondary progressive. Patient ability to perform activities frequently decreases and the need for informal caregiving increases. Factors associated with caregiving for persons with MS aged 60+ have not been described. Design/Methods: Three cross-sectional paper-based surveys were administered including demographics, the MS Neuropsychological Questionnaire (MSNQ), MSQLI-54, and the Beck Depression Inventory. Patients completed the Symbol Digit Modalities Test upon enrollment and caregivers completed the MSNQ.Descriptive statistics determined differences between patients with and without a caregiver. Results: 211 patients returned their first survey, 188 the second, and 179 the third. 43% of patients have SPMS and 35% have RRMS. 65% have a caregiver and 80% live with their caregiver. Those with a caregiver have a higher MSNQ score (28.7 +/- 9.4 vs. 25.8 +/- 7.8, p<0.05) and BDI score (10.1 +/- 8.5 vs. 6.6 +/- 6.1, p<0.05) than those without. Alternatively, those with a caregiver have a lower SDMT score than those without (30.2 +/- 11.0 vs. 37.2 +/- 9.3, p<0.05). Patients with a caregiver compared to those without have lower mean MSQLI composite scores in physical health (46.5 +/- 20.2 vs. 58.1 +/- 18.0, p<0.05) and mental health (62.2 +/- 21.1 vs. 72.4 +/- 17.9, p<0.05). Conclusions: MS patients with a caregiver have higher levels of depression and neuropsychological impairment than those without. They also have lower levels of cognition, and physical and mental health. This has implications for patients with progressive MS as it suggests that those patients with poorer overall health and cognition will need a caregiver for daily assistance.