Sahadevan S, Lim P P, Choo P W
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.
Int J Geriatr Psychiatry. 1999 Apr;14(4):266-71.
This survey aims to study the medical, functional and social aspects of hospitalized elderly patients with dementia.
The case records of 100 patients with dementia admitted consecutively to our department were systematically reviewed to extract the patients' demographic data, presenting features, underlying cause(s) of dementia, functional disabilities and carers' difficulties.
Eighty per cent of the patients were 75 years of age and above and 44% were males. In this cohort 55% had vascular dementia, with Alzheimer's disease being the next most common (40%). The overwhelming majority had marked cognitive impairment as assessed by the Abbreviated Mental Test and worsening degrees of dementia were significantly associated with increasing disabilities in both mobility and activities of daily living (ADL). Fifty-seven families reported coping difficulties and this group had significant correlations with the respective patients' bladder and bowel incontinence as well as worsening states of ambulatory and ADL function.
Patients with dementia present with complex problems and management requires attention not only to patients' medical problems and rehabilitation strategies but also to education, emotional support and help for their frequently stressed out carers.
本调查旨在研究住院老年痴呆患者的医学、功能和社会方面情况。
对连续入住我科的100例痴呆患者的病历进行系统回顾，以提取患者的人口统计学数据、临床表现、痴呆的潜在病因、功能障碍及照料者的困难之处。
80%的患者年龄在75岁及以上，44%为男性。在该队列中，55%患有血管性痴呆，其次最常见的是阿尔茨海默病（40%）。绝大多数患者经简易精神状态检查表评估有明显认知障碍，痴呆程度加重与活动能力和日常生活活动（ADL）能力下降显著相关。57个家庭报告存在应对困难，且该组与相应患者的大小便失禁以及活动和ADL功能恶化状态显著相关。
痴呆患者存在复杂问题，管理不仅需要关注患者的医学问题和康复策略，还需要关注对其经常压力过大的照料者的教育、情感支持和帮助。
