Caregiver burden can increase when elderly patients and caregivers rate the patient’s physical function differently, according to a study published in The Oncologist.1

Patients with advanced cancer increasingly receive outpatient care. Caregivers, familial or otherwise, are often employed in this setting to help patients with daily activities. To determine whether caregiver burden is affected by discrepancies in the patient’s and caregiver’s assessments of the patient’s physical health, researchers reviewed data from 100 cancer cases.

Each patient and corresponding caregiver completed an assessment of the patient’s overall health independently. The median patient age was 70; 70% of patients had advanced disease (26% of patients had lymphoma, 19% had breast cancer, and 15% had a gastrointestinal cancer). The median caregiver age was 66; 68% were patient-spouses.

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Patients and caregivers rated directly observable problems similarly (eg, number of falls and comorbid conditions). But caregivers also rated patient Karnofsky Performance Status (KPS) as lower (mean scores: 81 vs 84, respectively), and patient physical dependency as higher (determined by how many instrumental activities of daily living [IADLs] the patient required assistance with).

Caregivers were more likely to have greater care-related burden when patients reported requiring help with fewer IADLs than did the caregiver.

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The authors concluded that “assessing both patients and caregivers is important when utilizing caregivers as proxies for understanding patient function and when assessing for burden in caregivers of older adults with cancer.”


  1. Hsu T, Loscalzo M, Ramani R, et al. Are disagreements in caregiver and patient assessment of patient health associated with increased caregiver burden in caregivers of older adults with cancer? Oncologist. 2017 Aug 14. doi: 10.1634/theoncologist.2017-0085 [Epub ahead of print]