López-Pousa S, Vilalta-Franch J, Garre-Olmo J, Pons S, Cucurella M G
Unitat de Valoracío de la Memòria, i les Demècies, Hospital Santa Caterina, Salt, Girona, Espana.
Rev Neurol. 2007;45(11):683-8.
To assess the prevalence of behavioural and psychological symptoms (BPS's) in patients with dementia in Spain and their dementia-specific characteristics.
A cross-sectional and retrospective study of 1025 patients from 52 specialized dementia care units using the Neuropsychiatric Inventory (NPI). Patients with a probable diagnosis of Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and Parkinson's disease and dementia (PDD) were selected for BPS's characterisation.
The global prevalence of BPS's was 66.7% (684 patients; 95% CI = 63.8-69.6%). BPS's were under-diagnosed in one third of cases. A total of 668 patients with NPI of 4 or superior and a diagnosis of AD (n = 380; 56.8%), DLB (n = 156; 23.3%) and PDD (n = 132; 19.7%) had a NPI mean of 21.1 (SD = 14.7), 25.6 (SD = 13.9) and 21.8 (SD = 14.2), respectively. Apathy, depression and anxiety were the most common BPS's. Delusions and hallucinations were significantly more prevalent in DLB. Dementia severity was correlated with the global NPI value and with all the sub-items, but anxiety and euphoria. The presence of agitation, euphoria or lability was associated with a deficient therapeutic fulfillment.
A high prevalence of non-diagnosed BPS's was observed in the studied population. This has serious negative consequences for the quality of life of patients and their social environment. Therefore we propose an active search and subsequent correct treatment of BPS's in all patients with dementia.
评估西班牙痴呆患者行为和心理症状(BPS)的患病率及其痴呆特异性特征。
使用神经精神科问卷(NPI)对来自52个专业痴呆护理单元的1025例患者进行横断面回顾性研究。选择可能诊断为阿尔茨海默病(AD)、路易体痴呆(DLB)以及帕金森病痴呆(PDD)的患者进行BPS特征分析。
BPS的总体患病率为66.7%(684例患者;95%置信区间=63.8 - 69.6%)。三分之一的病例中BPS未被诊断出来。共有668例NPI评分为4分及以上且诊断为AD(n = 380;56.8%)、DLB(n = 156;23.3%)和PDD(n = 132;19.7%)的患者,其NPI均值分别为21.1(标准差=14.7)、25.6(标准差=13.9)和21.8(标准差=14.2)。冷漠、抑郁和焦虑是最常见的BPS。妄想和幻觉在DLB中显著更常见。痴呆严重程度与NPI总分及所有子项目相关,但与焦虑和欣快无关。激越、欣快或情绪不稳定的存在与治疗效果不佳相关。
在所研究人群中观察到未诊断出的BPS患病率很高。这对患者的生活质量及其社会环境具有严重的负面影响。因此,我们建议对所有痴呆患者积极筛查并随后正确治疗BPS。