Tilting the balance toward motor symptoms: Determinants of caregiver burden in late-stage Parkinson's disease.

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BackgroundCaregiver burden in Parkinson's disease (PD) is influenced by both motor and non-motor symptoms; however, the relative contribution of these domains in late-stage PD remains unclear. This study aimed to examine the clinical determinants of caregiver burden and to explore whether motor-functional impairment plays a relevant role in advanced PD.MethodsThirty patient-caregiver dyads were enrolled. Individuals with late-stage PD (Hoehn and Yahr stage IV) underwent a comprehensive clinical evaluation assessing motor performance, cognitive functioning and functional autonomy. Caregiver burden was assessed using a multidimensional self-report questionnaire. Associations were analyzed using Spearman correlations with false discovery rate correction. Multivariable linear regression models were fitted to explore independent contributors across motor, sleep, and QoL domains.ResultsCaregiver burden was associated with longer caregiving duration (ρ = 0.81, p_FDR ConclusionsIn advanced PD, caregiver burden is driven by motor-functional dependence and loss of autonomy, with sleep disturbance and perceived mobility-related impairment further contributing. These findings underscore the role of motor-functional disability in shaping caregiver strain in late-stage disease, highlighting the need for integrated, caregiver-centered management strategies.BackgroundCaregiver burden in Parkinson's disease (PD) is influenced by both motor and non-motor symptoms; however, the relative contribution of these domains in late-stage PD remains unclear. This study aimed to examine the clinical determinants of caregiver burden and to explore whether motor-functional impairment plays a relevant role in advanced PD.MethodsThirty patient-caregiver dyads were enrolled. Individuals with late-stage PD (Hoehn and Yahr stage IV) underwent a comprehensive clinical evaluation assessing motor performance, cognitive functioning and functional autonomy. Caregiver burden was assessed using a multidimensional self-report questionnaire. Associations were analyzed using Spearman correlations with false discovery rate correction. Multivariable linear regression models were fitted to explore independent contributors across motor, sleep, and QoL domains.ResultsCaregiver burden was associated with longer caregiving duration (ρ = 0.81, p_FDR ConclusionsIn advanced PD, caregiver burden is driven by motor-functional dependence and loss of autonomy, with sleep disturbance and perceived mobility-related impairment further contributing. These findings underscore the role of motor-functional disability in shaping caregiver strain in late-stage disease, highlighting the need for integrated, caregiver-centered management strategies.

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