Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, Australia Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
University of Melbourne, Austin Hospital, Melbourne, Australia.
J Alzheimers Dis. 2014;40(1):221-6. doi: 10.3233/JAD-131850.
Patients with dementia often require institutionalization when they can no longer care for themselves. The study examined demographic and clinical variables that predict the time until institutionalization in patients with dementia attending memory clinics. Of 970 patients recruited from nine memory clinics around Australia, 779 patients had dementia at baseline. Measures of dementia severity, cognition, functional ability, neuropsychiatric symptoms, caregiver burden, and medication use were completed for all patients. Patients were followed for three years. Overall, 197 (25.3%) of the patients with dementia were institutionalized within three years. Lower cognitive ability, lower functional ability, and more neuropsychiatric symptoms at baseline predicted a shorter time until institutionalization, as did use of antipsychotic medication. In addition, greater deterioration in cognitive ability, functional ability, and neuropsychiatric symptoms over the initial three months predicted a shorter time to institutionalization. The findings confirm that clinical features of dementia at baseline predict the time to institutionalization, as do greater changes in symptoms over three months independent of baseline levels.
当痴呆患者无法自理时，通常需要住院治疗。本研究考察了预测痴呆患者在记忆门诊就诊时入院时间的人口统计学和临床变量。在澳大利亚 9 家记忆诊所招募的 970 名患者中，779 名患者在基线时患有痴呆症。对所有患者进行了痴呆严重程度、认知、功能能力、神经精神症状、照顾者负担和药物使用的评估。患者随访了 3 年。总体而言，779 名痴呆症患者中有 197 人（25.3%）在三年内被收容入院。基线时认知能力较低、功能能力较低和神经精神症状较多的患者，以及使用抗精神病药物的患者，入院时间较短。此外，最初 3 个月内认知能力、功能能力和神经精神症状的恶化程度更大，预示着入院时间更短。研究结果证实，基线时的痴呆临床特征以及 3 个月内症状的变化情况均预测了收容入院的时间，而与基线水平无关。
