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Associations between patient quality of life and caregiver burden among older adults receiving comprehensive geriatric assessment via telemedicine: a cross-sectional study from Seha Virtual Hospital, Saudi Arabia
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DOI：10.1186/s12877-026-07951-4.png)
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Abstract
En 中文
Comprehensive geriatric assessment (CGA) is a multidimensional approach that aims to coordinate care for older adults, improve their quality of life, and reduce caregiver burden. Telemedicine extends CGA to bedbound patients, those with mobility limitations, and those living in remote areas. Saudi Arabia is undergoing rapid demographic aging while the Ministry of Health scales the Seha Virtual Hospital (SVH), yet published evaluations of its tele-geriatric service are scarce. We aimed to examine the association between patient quality of life and caregiver burden among older adults who received CGA via telemedicine at SVH. We conducted a cross-sectional observational study of patients aged 60 years or older who had received CGA via telemedicine at SVH between June 2022 and February 2024. Of 311 eligible patients, 146 caregivers completed the survey (response rate 46.9%). Quality of life was measured with the Arabic-validated EQ-5D-5L and caregiver burden with the abridged Arabic Zarit Burden Interview (ZBI-12). Because a substantial proportion of patients were bedbound or cognitively impaired, the EQ-5D-5L was completed by the primary caregiver as a proxy report. Patient data were extracted by retrospective chart review, and associations were tested with chi-square or Fisher exact tests. Five binary logistic regression models, each adjusted for patient age and sex, estimated the independent association between each EQ-5D-5L domain and ZBI-12-defined caregiver burden (total greater than 10). Reporting follows the STROBE statement. After adjustment, three EQ-5D-5L domains remained independently associated with caregiver burden: difficulty with usual activities (adjusted odds ratio 4.99, 95% CI 1.56 to 16.03), pain or discomfort (adjusted odds ratio 2.66, 95% CI 1.08 to 6.55), and anxiety or depression (adjusted odds ratio 2.42, 95% CI 1.09 to 5.35). Self-care attenuated to non-significance after adjustment, and mobility was not significant. The mean ZBI-12 score was 14.6 (SD 7.8), and 68.1% of caregivers met the burden threshold. Caregivers of patients with documented dementia carried a substantially higher mean burden score than those without dementia (16.8 versus 12.6; p = 0.002). In this Saudi tele-geriatric cohort, patient functional and psychological impairments were independently associated with elevated caregiver burden after adjustment for demographics. The cross-sectional design precludes causal inference; longitudinal studies with pre-assessment baseline data are warranted. The findings support integration of caregiver-targeted intervention into tele-geriatric service models, in line with the goals of the Saudi Vision 2030 health transformation.
Keywords:
Comprehensive geriatric assessment
Caregiver burden
Quality of life
Telemedicine
Saudi Arabia
EQ-5D-5L
Zarit Burden Interview
Older adults
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