Patient factors associated with caregiver burden in informal caregivers of older adults with cancer: A multicentre cross-sectional study

INTRODUCTION: Informal caregivers are essential to the care of older adults with cancer but may experience strain. We identified patient factors associated with burden in informal caregivers of older adults with cancer and described geriatric assessment (GA)-based recommendations for informal caregivers with burden. MATERIALS AND METHODS: This cross-sectional study included older adults (≥70 years) with cancer and a geriatric risk profile (G8 ≤ 14/17) from three centres in Belgium. All participants underwent a GA and received GA-based recommendations. Informal caregivers completed the 12-item Zarit Burden Interview (ZBI-12). Data were collected using a case report form. Logistic regression identified factors associated with significant caregiver burden (ZBI-12 ≥ 10). RESULTS: Between July 2012 and Jun 2015, of 900 eligible patients, 349 informal caregivers completed the ZBI-12; 149 (42.7%) reported significant caregiver burden (ZBI-12 ≥ 10). In univariate analysis, poorer Eastern Cooperative Oncology Group performance status (ECOG-PS 3-4; OR 2.27, 95% CI 1.41-3.70), higher activities of daily living (ADL) score (OR 1.09, 95% CI 1.02-1.15), longer Timed Up and Go test time (OR 1.04, 95% CI 1.00-1.07), higher patient fatigue score (OR 1.13, 95% CI 1.05-1.22), lower instrumental activities of daily living (iADL) score (OR 0.78, 95% CI 0.71-0.86), lower Mini-Mental State Examination score (OR 0.92, 95% CI 0.74-0.98), lower Mini Nutritional Assessment Short-Form score (OR 0.90, 95% CI 0.83-0.97), and greater comorbidity burden (OR 1.13, 95% CI 1.02-1.26) were associated with increased caregiver burden. In multivariable analysis, decreased iADL (OR 0.79, 95% CI 0.71-0.87) and increased patient fatigue (OR 1.11, 95% CI 1.02-1.19) were independent predictors of caregiver burden. Among informal caregivers with significant burden, the most common GA-based recommendations were nutritional counselling (113 [77.4%]) and medication adjustments (41 [28.1%]). DISCUSSION: Decreased ability to perform iADL and increased patient fatigue were independently associated with caregiver burden in older adults with cancer and should be considered in oncogeriatric assessment. GA-based recommendations, particularly nutritional support and medication review, provide actionable targets to support this population.