老年认知障碍患者共病状态与照料者负担相关性研究  

Association between caregiver burden and comorbidity in elderly patients with cognitive impairment

作　　者：李放[1] 苏卫红[1] 刘和锦[1] 张新焕[1] 王丽军[1] Li Fang;Su Weihong;Liu Hejin;Zhang Xinhuan;Wang Lijun(Department of Geriatric ,Fuxing Hospital ,Capital Medical University, 100045 Beijing ,China)

机构地区：[1]首都医科大学附属复兴医院综合科,100045

出　　处：《中华老年医学杂志》2018年第7期743-746,共4页Chinese Journal of Geriatrics

基　　金：首都特色基金项目（Z141107002514177）

摘　　要：目的探讨老年认知障碍患者共病和照料者负担的相关性。方法选取2014年9月至2016年9月于复兴医院老年记忆门诊与综合科、神经科住院患者共212例，按认知障碍程度分为非痴呆与痴呆组，对照料者发放调查问卷。使用简明精神状态量表（MMsE）、听觉词语学习测验（AVLT）、日常活动能力（ADL）、神经精神问卷（NPI）等评定患者认知总体水平、词语记忆、日常生活能力和精神行为症状。使用Charlson共存疾病指数（CCI）评估老年人共病情况，Zarit照料者负担调查问卷（ZBI）评估照料者负担。结果ZBI得分与患者的年龄、性别、CCI、MMSE、NPI、ADL评分均相关。患者为男性时照料者ZBI（21．21±11．24）分较女性患者（18．33±10．38）分高（P〈0．01）。ZBI与年龄（r=0．10，P〈O．001）、NPI（r=0．32，P〈0．001）、ADL（r=0．29，P〈0．001）和CCI（r=0．38，P〈0．001）呈正相关，与MMSE（r=-0．28，P〈0．001）呈负相关。进一步行多元回归分析，MMSE、NPI、ADL、CCI等因素进入回归方程；将CCI按不同认知障碍程度分别为CCI非疾呆、CCI疾呆后，多元回归分析结果为MMSE、NPI、ADL、CCI疾呆进入回归方程。结论认知障碍患者的认知功能下降以及相关的日常生活能力丧失、精神行为症状等是照料者负担的主要来源。此外，患者共存疾病数量和严重程度，是照料者负担的独立因素。Objective To examine the association between caregiver burden and comorbidity in elderly patients with cognitive impairment. Methods The study was conducted in 212 patients at the Memory Clinic and the Departments of Geriatrics and Neurology of Fuxing Hospital from September 2014 to September 2016. Recruited patients were assigned into a dementia group and a non-dementia group according to their cognitive status and were examined using mini mental state examination （MMSE）, auditory verbal learning test （AVLT）, activity of daily living （ADL）, neuropsychiatric inventory（NPI）, and Charlson eomorbidity index（CCI）. Their caregivers were surveyed with Zarit burden inventory （ZBI）. Results The ZBI score was significantly correlated with patients＇ age, gender, CCI, MMSE, NPI, and ADL. The ZBI score was higher in male patients（21.21 ± 11.24）than in female patients（18.33± 10.38）. Age（r = 0.10,P d0. 001） ,NPI（r = 0.32,Pd0. 001）, ADL（r = 0.29, P ± 0.001 ）, and CCI （r = 0.38, P ± 0.001 ） were positively correlated with caregiver burden, while MMSE（r =- 0.28, P d0. 001）was negatively correlated with it. Multiple linear regression model analysis indicated that MMSE, NPI, ADL, and CCI were influencing factors for earegiver burden. When CCI was stratified into CCInodementia and CCI dementia· influencing factors for caregiver burden were identified as MMSE, NP1, ADL, and CCIdementia ·Conclusions Cognitive deterioration, decrease in ADL,and neuropsychiatric symptoms in elderly patients are the major causes of increased caregiver burden. Besides, the number and severity of comorbidity are independent factors for caregiver burden.

关 键 词：认知障碍 共病 照料者 

分 类 号：R749.1[医药卫生—神经病学与精神病学]