Pritzker School of Medicine (TMM), The University of Chicago, Chicago, IL 60637, USA.
Am J Geriatr Psychiatry. 2012 Apr;20(4):298-305. doi: 10.1097/JGP.0b013e318235b758.
: The symptom experience of community-dwelling persons with dementia adopting an open-ended approach has not been well documented. We sought to identify the most bothersome symptoms experienced using self and caregiver report, and to evaluate whether these symptoms are captured by commonly used symptom-assessment measures including the Edmonton Symptom Assessment System (ESAS, standard in palliative care), Neuropsychiatric Inventory (NPI), and End-of-Life Dementia Scale-Symptom Management (ELDS-SM).
: The authors use data from the Palliative Excellence in Alzheimer Care Efforts (PEACE) study to characterize the symptom experience.
: PEACE included outpatient primary care geriatric patients in an urban setting affiliated with the University of Chicago.
: Data were examined from the 150 patient-caregiver dyads.
: The most bothersome symptoms of persons with dementia during the past week were reported separately by self and family caregiver. Symptoms were asked in an open-ended format and qualitative analysis using constant comparative technique was applied for each response. Reports were categorized and frequencies tabulated.
: One hundred fifteen persons (35 could not respond to the interview questions) with dementia reported 135 symptoms (median 1, range: 0-3). The most frequently reported symptoms were pain (N = 48; 42%), depression (N = 13; 11%), cognitive deficit (N = 12; 10%), anxiety (N = 7; 6%), and ophthalmologic complaint (N = 5; 4%). One hundred fifty caregivers reported 259 symptoms (median 2, range: 0-5) with cognitive deficit (N = 71; 47%), pain (N = 46; 30%), depression (N = 26; 17%), activity disturbance (N = 23; 15%), and thought and perceptual disturbances (N = 12; 8%) being reported most frequently. The ESAS, NPI, and ELDS-SM missed two or more of the most commonly reported symptoms by dyads of persons with dementia and their family caregivers.
: Symptoms were frequently reported by persons with dementia and their caregiver; however, commonly used symptom assessment measures overlooked important symptoms. All physicians should be vigilant about screening for both psychologic and physical symptoms in this population.
采用开放式方法对居住在社区的痴呆症患者的症状体验尚未有详细的记录。我们试图通过自我和护理人员报告来确定最困扰的症状，并评估这些症状是否可以通过常用的症状评估方法来评估，包括埃德蒙顿症状评估系统（ESAS，在姑息治疗中常用）、神经精神疾病问卷（NPI）和临终期痴呆症量表-症状管理（ELDS-SM）。
作者使用来自姑息治疗阿尔茨海默病努力卓越（PEACE）研究的数据来描述症状体验。
PEACE 包括在芝加哥大学附属城市地区的门诊老年患者。
数据来自 150 个患者-护理人员对。
过去一周内痴呆症患者最困扰的症状分别由自我和家庭护理人员报告。以开放式格式询问症状，并对每个回答使用恒定性比较技术进行定性分析。报告进行分类并制表。
150 名痴呆症患者（35 名无法回答访谈问题）报告了 135 种症状（中位数 1，范围：0-3）。报告最频繁的症状是疼痛（48 例；42%）、抑郁（13 例；11%）、认知缺陷（12 例；10%）、焦虑（7 例；6%）和眼科投诉（5 例；4%）。150 名护理人员报告了 259 种症状（中位数 2，范围：0-5），认知缺陷（71 例；47%）、疼痛（46 例；30%）、抑郁（26 例；17%）、活动障碍（23 例；15%）和思维和知觉障碍（12 例；8%）报告最频繁。ESAS、NPI 和 ELDS-SM 错过了患者及其家属报告的两个或更多最常见症状。
痴呆症患者及其护理人员经常报告症状；然而，常用的症状评估方法忽略了重要的症状。所有医生都应该警惕这一人群的心理和身体症状。
