McClendon McKee J, Smyth Kathleen A, Neundorfer Marcia M
University Memory and Aging Center, Case Western Reserve University and University Hospitals of Cleveland, 12200 Fairhill Road, Cleveland, OH 44120, USA.
J Gerontol B Psychol Sci Soc Sci. 2006 Jul;61(4):P220-7. doi: 10.1093/geronb/61.4.p220.
Although long-term-care (LTC) placement may shorten the survival of persons with Alzheimer's disease, studies have not examined whether the timing of placement matters. A sample of 258 persons with Alzheimer's disease and their family caregivers was used in a Cox survival model that included care-recipient impairments, caregiver characteristics, and LTC placement as covariates. Placement was associated with shortened survival, but the later the placement, the smaller the impact of placement on survival time. In an elaboration on prior work, the increased risk of death associated with wishfulness-intrapsychic caregiver coping was found to occur independently of LTC placement. This is the first study to link delayed LTC with a reduced risk of death in Alzheimer's disease. Interventions to assist family caregivers in the home are indeed appropriate; nevertheless, these findings may help long-term caregivers accept eventual institutionalization for their care recipients when care at home threatens their own health.
尽管长期护理（LTC）安置可能会缩短阿尔茨海默病患者的生存期，但研究尚未考察安置时间是否重要。在一个Cox生存模型中，使用了258名阿尔茨海默病患者及其家庭护理人员的样本，该模型将受护理者的损伤、护理人员的特征以及长期护理安置作为协变量。安置与生存期缩短有关，但安置时间越晚，安置对生存时间的影响就越小。在对先前工作的详细阐述中，发现与一厢情愿的内心护理人员应对方式相关的死亡风险增加独立于长期护理安置。这是第一项将延迟长期护理与阿尔茨海默病死亡风险降低联系起来的研究。协助家庭护理人员在家中护理的干预措施确实是合适的；然而，这些发现可能有助于长期护理人员在居家护理威胁到自身健康时，接受最终将其护理对象安置到机构中的做法。
