养老机构老年痴呆患者行为精神症状与照料者负担的相关性  

The relationship between psychiatric symptoms and burden of caregivers in senile dementia patients

作　　者：刘彩霞[1] 许瑛[1] 严静[1] 金肖青[1] 解艳红[1] 汤鸿鹰[1] 李君[1] 

机构地区：[1]浙江医院老年科,杭州310013

出　　处：《中华老年医学杂志》2017年第5期522-527,共6页Chinese Journal of Geriatrics

基　　金：港澳台科技合作专项项目（2014DFT30100）;浙江省医药卫生一般研究计划（A类,2015KYA004）

摘　　要：目的调本老年痴呆患者行为精神症状（BPSD）的发生情况及严重程度，探讨养老机构老年痴呆患者痴呆程度、BPSD程度与照料者负担的相关性。方法采用便利抽样方法，采用国际通用的临床痴呆评定量表（CDR）、神经精神量表（NPI）、Zarit照顾者负担量表（ZBI）对杭州市养老机构145例已确诊的老年痴呆患者及其照料者负担进行评估。结果51．8％（72例）的患者出现过不同程度BPSD，发生率较高的为妄想22．3％（31例），程度较重的为睡眠／夜间行为[NPI症状得分（5．95±4．60）分]，照料者负担最重的症状为妄想（ZBI得分（32．81±17．66）分]；老年痴呆患肯痴呆严重程度、NPI评分与照料者负担均呈正相关（F=0．434、0．710，均P〈0．01）。结论老年痴呆患者BPSD发生牢较高，且BPSD的发生与简易精神状态量衷（MMSE）评分、痴呆严重程度相关，加重了照料者的负担，应更多关注老年痴呆患者BPSD，完善老年痴呆患者及其照料者的衬会支持体系。Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia（BPSD）in elderly dementia patients,and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency. Methods Using a convenient sampling method,the Clinical Dementia Rating（CDR）scale, neuropsychlatric scale （NPI）and Zarit caregiver burden scale（ZBI）were used to evaluate 145 patients with Alzheimer＇s disease and caregiver burden in Hangzhou. Results The incidence rate of BPSI） was 51.8% （72 cases）, with a higher incidence rate of delusions of 22.3% （31 cases）,a higher severity of sleep disorder/nocturnal behavior [NPI symptom score （5.95 ± 4.60） points] .The symptom making a greatest burden on the caregivers was delusion[ZBI score （32.81±17.66） points] .There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD （r=0,434,0.710,all P〈0.01）in patients with senile dementia. Conclusions The incidence rate of BPSD in dementia patients is higher, and the occurrence of BPSD is associated with the severity of mini mental state examination（ MMSE） and dementia, which increases the burden of caregivers, More attention should be paid to BPSD in patients with senile dementia. And the social support system serving patients with senile dementia and their caregivers should be further improved.

关 键 词：痴呆 行为症状 精神障碍 

分 类 号：R749.16[医药卫生—神经病学与精神病学]