Berger Gabriele, Bernhardt Tanja, Weimer Erik, Peters Juergen, Kratzsch Tilman, Frolich Lutz
Department of Psychiatry and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
J Geriatr Psychiatry Neurol. 2005 Sep;18(3):119-28. doi: 10.1177/0891988704273375.
The objective was to evaluate the course and severity of dementia-related symptoms and their relationship to caregivers' subjective burden and depression over time. Forty-five patients with dementia and their caregivers were followed over a period of 2 years. Patients' cognition, function, and behavioral/psychological symptoms were assessed by the Mini Mental State Examination, Syndrome Kurz Test, Geriatric Depression Screening scale, Instrumental Activities of Daily Living Scale, Physical Self Maintenance Scale, Behavioral Abnormalities in Alzheimer's Disease Rating Scale, and Nurses Observation Scale for Geriatric Patients. Caregivers' depression and subjective burden were evaluated by the Geriatric Depression Screening scale or Beck Depression Inventory and the Caregiver Burden Interview. Global dementia severity, functional impairment, and behavioral disturbances increased significantly over the 2-year observation period. Caregivers' burden remained stable, and severe depression decreased over time. There were significant associations between burden and dementia-related symptoms. For deficits in activities of daily living as well as behavioral disturbances, these associations became stronger over time. It was concluded that stage of dementia, functional deficits, and behavioral disturbances are important factors when evaluating the relationship between patients' symptoms and caregivers' well-being.
目的是评估与痴呆相关症状的病程和严重程度,以及随着时间推移这些症状与照料者主观负担和抑郁之间的关系。45名痴呆患者及其照料者被随访了2年。通过简易精神状态检查表、库尔茨综合征测试、老年抑郁筛查量表、日常生活活动能力量表、身体自我维持量表、阿尔茨海默病行为异常评定量表和老年患者护士观察量表对患者的认知、功能及行为/心理症状进行评估。通过老年抑郁筛查量表或贝克抑郁量表以及照料者负担访谈来评估照料者的抑郁和主观负担。在2年的观察期内,痴呆的整体严重程度、功能损害和行为障碍显著增加。照料者的负担保持稳定,重度抑郁随时间减少。负担与痴呆相关症状之间存在显著关联。对于日常生活活动缺陷以及行为障碍,这些关联随着时间推移变得更强。研究得出结论,在评估患者症状与照料者幸福感之间的关系时,痴呆阶段、功能缺陷和行为障碍是重要因素。