Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan.
Psychiatry Clin Neurosci. 2011 Aug;65(5):459-67. doi: 10.1111/j.1440-1819.2011.02249.x.
'Successful aging' in individuals with schizophrenia has been attracting attention. We examined two forward-looking factors of successful aging among schizophrenia patients: 'attitude toward aging' and 'preparing behavior for old age'.
Fifty-seven middle-aged and elderly schizophrenia patients with successful aging were identified using the Attitude toward Aging Scale, the Preparing Behavior for Old Age Scale, and assessments of their cognitive function, psychiatric symptoms, social functioning and quality of life. A multiple regression analysis was used to detect determinants of attitude toward aging/preparing behavior for old age at that time ('present': community dwelling). We also analyzed predictors of successful aging using demographic/clinical data assessed 3 years previously ('past': residential care).
The multiple regression analysis revealed that quality of life was a significant determinant: a higher quality of life was related to a more positive attitude toward aging and less active preparing behavior. The significant predictors of preparing behavior were quality of life and the length of the hospital stay: a longer hospital stay and a higher quality of life were related to less active preparing behavior.
Quality of life and the length of the hospital stay significantly contributed to forward-looking factors of successful aging. Avoiding long hospitalization periods for patients with schizophrenia may lead to more active preparing behavior, but the improvement of quality of life may not be a sufficient condition. As schizophrenia patients have an optimistic attitude and insufficient preparing behavior, support to prepare such individuals for old age is required as part of community-based psychiatric care strategies.
个体的“成功老龄化”受到越来越多的关注。我们检验了精神分裂症患者成功老龄化的两个前瞻性因素:“老龄化态度”和“老年准备行为”。
使用老龄化态度量表、老年准备行为量表,以及认知功能、精神症状、社会功能和生活质量评估,我们确定了 57 名具有成功老龄化的中老年精神分裂症患者。采用多元回归分析,检测当时(“现在”:社区居住)老龄化态度/老年准备行为的决定因素。我们还使用 3 年前评估的人口统计学/临床数据(“过去”:住院护理),分析成功老龄化的预测因素。
多元回归分析显示,生活质量是一个重要的决定因素:较高的生活质量与更积极的老龄化态度和较少的积极准备行为有关。准备行为的显著预测因素是生活质量和住院时间:较长的住院时间和较高的生活质量与较少的积极准备行为有关。
生活质量和住院时间对成功老龄化的前瞻性因素有显著贡献。避免精神分裂症患者的长期住院可能会导致更积极的准备行为,但提高生活质量可能不是充分条件。由于精神分裂症患者持乐观态度但准备行为不足,因此需要为这些人提供支持,以准备他们进入老年期,这是基于社区的精神卫生保健策略的一部分。