Steinberg Martin, Tschanz JoAnn T, Corcoran Christopher, Steffens David C, Norton Maria C, Lyketsos Constantine G, Breitner John C S
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Int J Geriatr Psychiatry. 2004 Jan;19(1):19-26. doi: 10.1002/gps.1025.
To estimate the 18-month persistence of neuropsychiatric symptoms in dementia in a population-based sample, and to compare the severity of neuropsychiatric symptoms at baseline to the severity at 18-month follow-up.
A population-based sample of 329 residents of Cache County, Utah, diagnosed with dementia was rated on the Neuropsychiatric Inventory (NPI). Of the 204 participants with neuropsychiatric symptoms at baseline (defined as total NPI score >0), NPI data were obtained approximately 18 months later on 117 who were alive and available for follow-up.
Eighty-one percent of those with neuropsychiatric symptoms at baseline (defined as total NPI score>0) continued to have at least one symptom at follow-up. Sixty-seven percent of participants with a clinically significant total NPI score (defined as > or = 4) at baseline continued to have a clinically significant total NPI score at follow-up. Among the ten neuropsychiatric domains assessed at baseline, delusions persisted in 65.5% of individuals, followed by depression (58.3%), and aberrant motor behavior (55.6%), while hallucinations and disinhibition persisted in only 25.0% and 11.1% respectively. In participants who were symptomatic at both baseline and follow-up, the mean severity scores at the two observation points were comparable in all ten neuropsychiatric domains.
Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable.
在一个基于人群的样本中评估痴呆患者神经精神症状持续18个月的情况，并比较基线时与18个月随访时神经精神症状的严重程度。
对犹他州卡什县329名被诊断为痴呆的居民进行基于人群的抽样，并采用神经精神科问卷（NPI）进行评分。在基线时有神经精神症状（定义为NPI总分>0）的204名参与者中，约18个月后对117名存活且可进行随访的参与者获取了NPI数据。
基线时有神经精神症状（定义为NPI总分>0）的参与者中，81%在随访时仍至少有一项症状。基线时NPI总分具有临床意义（定义为≥4）的参与者中，67%在随访时NPI总分仍具有临床意义。在基线时评估的十个神经精神领域中，妄想在65.5%的个体中持续存在，其次是抑郁（58.3%）和异常运动行为（55.6%），而幻觉和脱抑制分别仅在25.0%和11.1%的个体中持续存在。在基线和随访时均有症状的参与者中，在所有十个神经精神领域中，两个观察点的平均严重程度评分相当。
痴呆患者的神经精神症状总体上具有高度持续性。在症状确实持续存在的患者中，一年半后的症状严重程度似乎相当。
