Quantifying the burden of caregiving in Duchenne muscular dystrophy

J Neurol. 2016 May;263(5):906-915. doi: 10.1007/s00415-016-8080-9. Epub 2016 Mar 10.


Duchenne muscular dystrophy (DMD) is a rare pediatric neuromuscular disease associated with progressive muscle degeneration and extensive care needs. Our objective was to estimate the caregiver burden associated with DMD. We made cross-sectional assessments of caregiver health-related quality of life (HRQL) and burden using the EuroQol EQ-5D, a Visual Analogue Scale (VAS), the SF-12 Health Survey, and the Zarit Caregiver Burden Interview (ZBI) administered online. Results were stratified by disease stage (early/late ambulatory/non-ambulatory) and caregivers' rating of patients' health and mental status. In total, caregivers to 770 patients participated. Mean EQ-5D utility ranged between 0.85 (95 % CI 0.82-0.88) and 0.77 (0.74-0.80) across ambulatory classes and 0.88 (0.85-0.90) and 0.57 (0.39-0.74) across caregivers' rating of patients' health and mental status. Mean VAS score was 0.74 (0.73-0.75), mean SF-12 Mental Health Component Summary score 44 (43-45), and mean ZBI score 29 (28-30). Anxiety and depression, recorded in up to 70 % of caregivers depending on patients' health and mental status, was significantly associated with annual household cost burden (>$5000 vs. <$1000, odds ratio 1.76, 95 % CI 1.18-2.63) and hours of leisure time devoted to informal care per week (25-50 vs. <25 h 2.01, 1.37-2.94; >50 vs. <25 h 3.35, 2.32-4.83) (p < 0.007). We show that caring for a person with DMD can be associated with a substantial burden and impaired HRQL. Our findings suggest that caregivers to patients with DMD should be screened for depression and emphasize the need for a holistic approach to family mental health in the context of chronic childhood disease.

Keywords: Caregiver burden; Informal care; Neuromuscular; Quality of life; Utilities.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Caregivers / psychology*
  • Cost of Illness*
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / etiology
  • Female
  • Humans
  • Male
  • Muscular Dystrophy, Duchenne / economics
  • Muscular Dystrophy, Duchenne / therapy*
  • Prevalence
  • Quality of Life
  • Socioeconomic Factors