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认知障碍老年人中行为和心理症状的存在及其向痴呆的进展。

The presence of behavioural and psychological symptoms and progression to dementia in the cognitively impaired older population.

机构信息

Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK.

出版信息

Int J Geriatr Psychiatry. 2013 Jul;28(7):700-9. doi: 10.1002/gps.3873. Epub 2012 Aug 10.

Abstract

OBJECTIVE

Behavioural and psychological symptoms (BPS) are common in the older population and may be an indication of early dementia. We explored the predictive effect of the presence of BPS on the 2-year progression to dementia in a cognitively impaired population aged 65 years and over without dementia at baseline.

METHODS

Twelve symptoms were measured in 2024 participants without dementia at baseline as part of a population-based longitudinal study of ageing. The risk of progression to dementia was predicted in those with cognitive impairment for each individual BPS and using a BPS composite score.

RESULTS

Wandering and persecution were independently associated with progression to dementia after adjustment for socio-demographic factors, cognitive domains and other BPS. When stratifying by cognitive function, those with low cognition (MMSE 0-18) and 4 or more BPS were more likely to progress to dementia than those without BPS.

CONCLUSIONS

We have shown that some psychiatric symptoms are associated with increased short-term progression to dementia in those with low cognition. The predictive effect of BPS in dementia progression has implications for risk stratification of those at high risk of progression to dementia, along with memory impairment, other cognitive impairment and health variables.

摘要

目的

行为和心理症状(BPS)在老年人中很常见,可能是早期痴呆的迹象。我们探讨了在认知障碍但基线时无痴呆的 65 岁及以上人群中,存在 BPS 对 2 年进展为痴呆的预测作用。

方法

在一项基于人群的老龄化纵向研究中,在 2024 名基线时无痴呆的参与者中测量了 12 种症状。在认知障碍患者中,根据每个单独的 BPS 和 BPS 综合评分,预测向痴呆的进展风险。

结果

调整社会人口因素、认知域和其他 BPS 后,徘徊和迫害与向痴呆的进展独立相关。当按认知功能分层时,认知功能较低(MMSE 0-18)和有 4 种或更多 BPS 的患者比没有 BPS 的患者更有可能进展为痴呆。

结论

我们已经表明,一些精神症状与认知功能较低的患者短期向痴呆进展的风险增加有关。BPS 在痴呆进展中的预测作用对那些有进展为痴呆风险、记忆力减退、其他认知障碍和健康变量高风险的人进行风险分层具有重要意义。

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