Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Neuropsychiatr Dis Treat. 2013;9:357-63. doi: 10.2147/NDT.S41581. Epub 2013 Mar 6.
Japan has become the world's most aged country. The percentage of elderly people in Japan is estimated to reach 25.2% in 2013, and the number of patients with dementia is estimated to reach 2.5 million in 2015. In addition to its deterioration of physical function and activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD) often become major clinical problems, greatly annoying patients and their caregivers. In Japan, we utilize wards for elderly patients with dementia (WEDs) for BPSD treatment. However, there are few studies investigating the effectiveness of treatment in a WED. In such treatment, physical complications are a challenge physicians must overcome while treating BPSD and safely returning patients home or to the institutions in which they live. Therefore, we investigated the effectiveness of treatment in a WED, focusing on physical complications.
The subjects were 88 patients who were admitted to and discharged from a WED. Severity of dementia, basic ADL, and BPSD were investigated using the Clinical Dementia Rating, Physical Self-Maintenance Scale (PSMS), and Neuropsychiatric Inventory. Differences in characteristics between patients discharged from the WED because of physical complications and all other patients were also examined.
We found significant improvements in the PSMS score and decreases in delusions and sleep disturbances in all patients. Patients discharged from the WED because of physical complications had significantly greater severity of dementia at discharge compared to all other patients.
Treatment in a WED seems to be effective for BPSD and ADL, but care should be taken regarding physical complications, especially in patients with advanced dementia.
日本已经成为世界上老龄化最严重的国家。预计到 2013 年，日本老年人的比例将达到 25.2%，到 2015 年，痴呆症患者的数量预计将达到 250 万。除了身体功能和日常生活活动（ADL）的恶化，痴呆症的行为和心理症状（BPSD）往往成为主要的临床问题，给患者及其护理人员带来极大的困扰。在日本，我们利用老年痴呆症患者病房（WED）来治疗 BPSD。然而，针对 WED 治疗效果的研究很少。在这种治疗中，身体并发症是医生在治疗 BPSD 并确保患者安全回家或返回居住机构时必须克服的挑战。因此，我们调查了 WED 治疗的效果，重点关注身体并发症。
研究对象为 88 名入住和出院的 WED 患者。使用临床痴呆评定量表、身体自我维护量表（PSMS）和神经精神问卷评估痴呆严重程度、基本日常生活活动和 BPSD。还比较了因身体并发症而从 WED 出院的患者与所有其他患者的特征差异。
我们发现所有患者的 PSMS 评分均显著改善，妄想和睡眠障碍均有所减少。因身体并发症而从 WED 出院的患者与所有其他患者相比，出院时痴呆严重程度显著更高。
WED 治疗似乎对 BPSD 和 ADL 有效，但应注意身体并发症，尤其是在痴呆症晚期患者中。
