Rullier Laetitia, Lagarde Alexia, Bouisson Jean, Bergua Valérie, Torres Marion, Barberger-Gateau Pascale
Univ. Bordeaux, Psychologie, Santé et Qualité de vie, EA4139, F-33000 Bordeaux, France.
Int Psychogeriatr. 2014 Jan;26(1):105-13. doi: 10.1017/S1041610213001579. Epub 2013 Sep 19.
This exploratory study investigated the associations of individual characteristics of both persons with dementia and family caregivers with the nutritional status of caregivers.
This cross-sectional study was conducted at home by psychogerontologist within the frame of a community gerontological center in rural areas of south west France. The study participants comprised 56 community-dwelling persons with dementia (mean 80.7 years, SD 6.5) and 56 family caregivers (mean 70.9 years, SD 11.0). Persons with dementia were assessed with Mini-Mental State Examination (MMSE), Basic Activities Of Daily Living (ADL), Instrumental ADL (IADL), and NeuroPsychiatric Inventory (NPI), and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory (STAI Y-B), the Center for Epidemiologic Studies Depression Scale (CES-D), the emotional impact measure of NPI and the Autonomy, Gerontology and Group Resources scale (AGGIR scale). For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA®).
Among family caregivers, 32.1% were at risk of malnutrition and 5.4% were malnourished, and among people with dementia, 58.9% and 23.2%, respectively. NPI severity score of apathy of persons with dementia (Beta = -0.342, p = 0.001), dependency on AGGIR scale (Beta = -0.336, p = 0.002), and CES-D score of caregivers (Beta = -0.365, p = 0.001) were associated with caregivers' MNA score (Adjusted R 2 = 0.480, p < 0.001).
These preliminary findings emphasize the need for routine assessment of depressive symptoms, functional and nutritional status in dementia family caregivers, and confirm the value of investigating caregivers' nutritional risk through an integrative view including psychosocial approach.
本探索性研究调查了痴呆症患者和家庭照顾者的个体特征与照顾者营养状况之间的关联。
本横断面研究由精神老年病学家在法国西南部农村地区的社区老年医学中心框架内于家中进行。研究参与者包括56名社区居住的痴呆症患者（平均年龄80.7岁，标准差6.5）和56名家庭照顾者（平均年龄70.9岁，标准差11.0）。对痴呆症患者进行简易精神状态检查表（MMSE）、日常生活基本活动能力（ADL）、工具性ADL（IADL）和神经精神科问卷（NPI）评估，对家庭照顾者进行负担访谈（扎里特量表）、状态-特质焦虑量表（STAI Y-B）、流行病学研究中心抑郁量表（CES-D）、NPI情绪影响量表和自主性、老年医学与群体资源量表（AGGIR量表）评估。对两者均使用微型营养评定法（MNA®）评估营养状况。
在家庭照顾者中，32.1%存在营养不良风险，5.4%营养不良；在痴呆症患者中，分别为58.9%和23.2%。痴呆症患者的NPI冷漠严重程度评分（β=-0.342，p=0.001）、AGGIR量表上的依赖性（β=-0.336，p=0.002）以及照顾者的CES-D评分（β=-0.365，p=0.001）与照顾者的MNA评分相关（调整后R²=0.480，p<0.001）。
这些初步研究结果强调了对痴呆症家庭照顾者的抑郁症状、功能和营养状况进行常规评估的必要性，并证实了通过包括社会心理方法在内的综合视角调查照顾者营养风险的价值。
