Seidl U, Lueken U, Völker L, Re S, Becker S, Kruse A, Schröder J
Sektion Gerontopsychiatrie, Psychiatrische Universitätsklinik Heidelberg.
Fortschr Neurol Psychiatr. 2007 Dec;75(12):720-7. doi: 10.1055/s-2007-959211. Epub 2007 Apr 27.
Dementias, in particular Alzheimer's disease (AD), are the main reason for availing of nursing home care. In the course of the illness, the clinical picture is affected by cognitive decline and by other psychopathological, "non-cognitive" symptoms such as apathy, depression, delusions or agitation. Little attention has been paid to these symptoms, although they lead to an increase in strain on the patients and their relatives as well as complications in nursing care. Psychopathological symptoms were evaluated by using the Neuropsychiatric Inventory in 145 nursing home residents (age: 85 +/- 7 years, duration of stay: 35 +/- 48 months); the majority of them with moderate to severe dementia (GDS: 5 +/- 2; MMSE: 11 +/- 9). In addition, the Apathy Evaluation Scale was applied. To meet potential regional effects, residents were recruited in nursing homes in the areas around Heidelberg as well as Munster. 87% of the participants showed psychopathological symptoms of an at least moderate degree, depressive mood (52%), apathy (41%) and agitation (38%) being most frequent. General condition, nutritional status and care status were evaluated as 'good', likewise general health care. In contrast, only 27% were treated by psychiatrists. 70% received psychopharmacological treatment, mostly sedatives (44%), while antidementive drugs were used only in 11%. The findings underline the need of further information and advanced training.
痴呆症,尤其是阿尔茨海默病(AD),是使用养老院护理服务的主要原因。在疾病过程中,临床表现受到认知衰退以及其他精神病理学“非认知”症状的影响,如冷漠、抑郁、妄想或躁动。尽管这些症状会增加患者及其亲属的负担以及护理并发症,但却很少受到关注。我们使用神经精神科问卷对145名养老院居民(年龄:85±7岁,入住时间:35±48个月)的精神病理学症状进行了评估;他们中的大多数患有中度至重度痴呆(总体衰退量表:5±2;简易精神状态检查表:11±9)。此外,还应用了冷漠评估量表。为了应对潜在的地区影响,我们在海德堡以及明斯特周边地区的养老院招募了居民。87%的参与者表现出至少中度程度的精神病理学症状,最常见的是抑郁情绪(52%)、冷漠(41%)和躁动(38%)。总体状况、营养状况和护理状况被评估为“良好”,整体医疗保健情况也是如此。相比之下,只有27%的人接受精神科医生的治疗。70%的人接受了精神药物治疗,主要是镇静剂(44%),而抗痴呆药物仅在11%的人身上使用。这些发现强调了进一步提供信息和进行高级培训的必要性。