Schultz Susan K, Ellingrod Vicki L, Moser David J, Kutschner Eric, Turvey Carolyn, Arndt Stephan
Department of Psychiatry, University of Iowa College of Medicine, 500 Newton Road, Iowa City, Iowa 52242-1000, USA.
Ann Clin Psychiatry. 2002 Dec;14(4):209-13. doi: 10.1023/a:1021964900323.
The influence of psychiatric symptoms and cognitive status on daily living skills was explored among persons with dementia residing in skilled nursing facilities. Psychiatric symptoms were examined in three domains: 1) depression, 2) psychosis, and 3) behavioral disturbances. Twenty-eight subjects were followed for a 1-year duration in rural nursing facilities. The relationship between psychiatric symptoms, cognition, and daily living skills was assessed using correlation and regression analyses. Over a one-year period, cognitive and functional impairment progressed significantly. In contrast, psychiatric symptoms across all three domains did not necessarily persist or increase. Deterioration in cognitive function was significantly correlated with reduced functional status both cross-sectionally and longitudinally. Among psychiatric symptoms, only behavioral disturbances were significantly associated with functional impairment cross-sectionally. Cognitive decline and loss of social functioning may constitute the greatest source of disability among persons in nursing facilities. Furthermore, both impairments increase over time in contrast to psychiatric symptoms, which appear to have a more variable course. These findings may have implications for treatment interventions that seek to enhance functioning in the skilled nursing setting.
在居住于专业护理机构的痴呆症患者中，探讨了精神症状和认知状况对日常生活技能的影响。精神症状在三个领域进行了检查：1）抑郁，2）精神病，3）行为障碍。28名受试者在农村护理机构接受了为期1年的随访。使用相关性和回归分析评估精神症状、认知和日常生活技能之间的关系。在一年的时间里，认知和功能障碍显著进展。相比之下，所有三个领域的精神症状不一定持续存在或增加。认知功能的恶化在横断面和纵向都与功能状态的降低显著相关。在精神症状中，只有行为障碍在横断面与功能损害显著相关。认知衰退和社会功能丧失可能是护理机构中患者残疾的最大来源。此外，与精神症状相比，这两种损害会随着时间的推移而增加，而精神症状的病程似乎更具变异性。这些发现可能对旨在提高专业护理环境中功能的治疗干预措施具有启示意义。
