Annals of Indian Academy of Neurology
LETTER TO THE EDITOR
Year
: 2016  |  Volume : 19  |  Issue : 3  |  Page : 417-

Choosing controls


Sunil Kumar Raina 
 Department of Community Medicine, DR. RPGMC, Tanda, Kangra, Himachal Pradesh, India

Correspondence Address:
Sunil Kumar Raina
Department of Community Medicine, DR. RPGMC, Tanda, Kangra, Himachal Pradesh
India




How to cite this article:
Raina SK. Choosing controls.Ann Indian Acad Neurol 2016;19:417-417


How to cite this URL:
Raina SK. Choosing controls. Ann Indian Acad Neurol [serial online] 2016 [cited 2020 Feb 25 ];19:417-417
Available from: http://www.annalsofian.org/text.asp?2016/19/3/417/186854


Full Text

Sir,

Went through with interest article entitled "Perceived caregiver stress in Alzheimer's disease and mild cognitive impairment: A case-control study" published in Ann Indian Acad Neurol (2016;19:58-62). [1] The authors deserve credit for highlighting an important area of concern in patient management.

However, I have a concern. The authors conducted the present study in a case-control study design mode with caregivers of patients diagnosed with Alzheimer's disease/mild cognitive impairment (AD/MCI) identified as cases while the controls included caregivers of patients with chronic medical and psychiatric disorders. [1] Accordingly, a total of 31 patients of AD/MCI (males = 24, females = 7), and 30 controls (males = 18, females = 12) were interviewed. On the basis of this, the authors conclude that caregivers of patients with AD/MCI have a high perceived stress compared to caregivers of patients with other chronic illness. Now, this is where my primary concern lies. Agreed that the study being a hospital-based case-control study and choosing suitable hospital controls is often difficult, but choosing the right controls is perhaps the most important step in a case-control study. [2] Herein, the authors have chosen controls which may not be similar to cases in variables (other than the variable of interest), which is a fundamental principle of case-control studies. This is clearly apparent in [Table 1] of the study (reproduced below). The mean age for caregivers of AD/MCI (cases) was 69 ± 11.86 years while for caregivers of chronic disorders it was much less at 56 ± 5.53 years. Similarly, the mean duration of illness was higher in AD/MCI as compared to caregivers of chronic disorders (controls). Other parameters which influence perceived stress including gender and social status has not been dealt with by the authors.{Table 1}

Further, it is known fact that caregivers of individuals with dementia suffer from caregiver burden more frequently than other caregiver groups and are more vulnerable for various health problems. [3] Therefore, matching for factors associated with caregiver burden such as the sociodemographic status of the caregiver and care recipient, the nature of the disease of the care-recipient, etc., assumes importance.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Anand KS, Dhikav V, Sachdeva A, Mishra P. Perceived caregiver stress in Alzheimer's disease and mild cognitive impairment: A case control study. Ann Indian Acad Neurol 2016;19:58-62.
2Raina SK. Age and sex matching in case-control studies. Lung India 2015;32:544.
3Kim H, Chang M, Rose K, Kim S. Predictors of caregiver burden in caregivers of individuals with dementia. J Adv Nurs 2012;68:846-55.