Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway.
Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.
Int Psychogeriatr. 2014 Mar;26(3):383-91. doi: 10.1017/S1041610213002032. Epub 2013 Nov 20.
The objective of this study was to (a) determine the prevalence of cognitive impairment, dementia, and neuropsychiatric symptoms (NPSs) among home-dwelling people, 70 years and older (70+ years), who receive domiciliary care, and (b) describe their use of psychotropic drugs. Few studies have investigated dementia among people receiving in-home care.
A sample (N = 1,000) representative of people aged 70+ years receiving domiciliary care was randomly recruited for participation. A standardized interview with the participants and their next of kin were performed using well-established assessment scales. Two clinical experts independently diagnosed dementia according to ICD-10 criteria.
Of the 415 participants (41.5%) with dementia according to ICD-10 criteria, 19.5% had a dementia diagnosis known to the patient themselves, their caregiver, or health workers in the domiciliary care service. In the previous month, 72.1% exhibited NPSs (21.1% rated as clinically significant), with depression (47.5%), apathy (33.7%), anxiety (33.0%), and irritability (31.1%) being the most common. Psychotropic drugs were regularly used by 40.1% of the sample. Antidepressants (p = 0.001) and cognitive enhancers (p < 0.001) were more often given to people with dementia than to those without dementia.
Dementia and NPSs are highly prevalent among people who receive domiciliary care, and diagnostic disclosure is low. People with dementia constitute a distinct group with respect to NPSs and psychotropic drug use. Early detection and correct diagnosis might increase the understanding of their everyday challenges and enable families to alleviate consequences of dementia and NPSs.
本研究旨在：(a)确定接受家庭护理的 70 岁及以上（70+岁）居家人群中认知障碍、痴呆和神经精神症状（NPSs）的患病率；(b)描述他们使用精神药物的情况。很少有研究调查接受家庭护理的人群中的痴呆症。
随机招募了一个代表性样本（n=1000），包括接受家庭护理的 70+岁人群。使用成熟的评估量表对参与者及其近亲属进行了标准化访谈。两名临床专家根据 ICD-10 标准独立诊断痴呆症。
根据 ICD-10 标准，415 名参与者（41.5%）患有痴呆症，其中 19.5%的患者本人、护理人员或家庭护理服务中的卫生工作者已知有痴呆症诊断。在过去一个月中，72.1%的人出现了 NPSs（21.1%被评定为具有临床意义），其中最常见的是抑郁（47.5%）、淡漠（33.7%）、焦虑（33.0%）和易怒（31.1%）。40.1%的样本定期使用精神药物。与没有痴呆症的人相比，患有痴呆症的人更常使用抗抑郁药（p=0.001）和认知增强剂（p<0.001）。
接受家庭护理的人群中痴呆症和 NPSs 患病率很高，诊断披露率较低。痴呆症患者在 NPSs 和精神药物使用方面构成了一个独特的群体。早期发现和正确诊断可能会增加对他们日常挑战的理解，并使家属能够减轻痴呆症和 NPSs 的后果。
