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阿尔茨海默病中减轻照料者负担的评估、措施及方法

Assessment, measures and approaches to easing caregiver burden in Alzheimer's disease.

作者信息

Farcnik Karl, Persyko Michelle S

机构信息

Neuropharmacology Clinic, Toronto Western Hospital, Ontario, Canada.

出版信息

Drugs Aging. 2002;19(3):203-15. doi: 10.2165/00002512-200219030-00004.

Abstract

The reduction of caregiver burden for those caring for patients with Alzheimer's disease (AD) is especially important given the prevalence of AD as populations age. This paper reviews the complex nature of caregiver burden, how it is measured, and possible interventions that may affect caregiver burden. Caregiver characteristics as well as symptoms exhibited by patients contribute to burden. A number of specific quantitative measures which have been developed to better evaluate caregiver burden are discussed. Such measures are also useful in measuring the impact of interventions on caregiver burden. Pharmacological treatment of patients with AD through the use of acetylcholinesterase inhibitors has positively affected cognition, activities of daily living, and behavioural problems. These benefits significantly reduce caregiver burden. The same is true for psychosocial interventions for the caregiver. It has been suggested that combining both approaches should be utilised for optimal management. Our knowledge of caregiver burden has greatly increased over the past two decades with clear benefits for both patients and caregivers. However, many aspects still clearly require further research. Given the significance of caregiver burden, various aspects have been extensively studied including contributing and protective factors, quantitative assessment, and pharmacological and psychosocial intervention. It is important for clinicians to be aware of this knowledge so that they can effectively incorporate it into their treatment plans for those affected by AD.

摘要

鉴于随着人口老龄化,阿尔茨海默病(AD)的患病率不断上升,减轻照顾AD患者的照料者负担尤为重要。本文综述了照料者负担的复杂性质、其测量方法以及可能影响照料者负担的干预措施。照料者的特征以及患者表现出的症状都会加重负担。文中讨论了一些为更好地评估照料者负担而制定的具体量化措施。这些措施在衡量干预措施对照料者负担的影响方面也很有用。通过使用乙酰胆碱酯酶抑制剂对AD患者进行药物治疗,对认知、日常生活活动和行为问题产生了积极影响。这些益处显著减轻了照料者的负担。照料者的心理社会干预也是如此。有人建议,应将这两种方法结合起来以实现最佳管理。在过去二十年里,我们对照料者负担的认识有了很大提高,这对患者和照料者都有明显益处。然而,许多方面显然仍需要进一步研究。鉴于照料者负担的重要性,人们已经对照料者负担的各个方面进行了广泛研究,包括促成因素和保护因素、量化评估以及药物和心理社会干预。临床医生了解这些知识很重要,这样他们才能有效地将其纳入针对AD患者的治疗计划中。

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