Vu M, Hogan D B, Patten S B, Jetté N, Bronskill S E, Heckman G, Kergoat M J, Hirdes J P, Chen X, Zehr M M, Maxwell C J
School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
Chronic Dis Inj Can. 2014 Jul;34(2-3):132-44.
This study provides a comprehensive summary of the sociodemographic, psychosocial and health characteristics of a large population-based cohort of Ontario home care clients (aged 50 years and over) with dementia and examines the variation in these characteristics in those with co-existing neurological conditions.
Clients were assessed with the Resident Assessment Instrument-Home Care (RAI-HC) between January 2003 and December 2010. Descriptive analyses examined the distribution of these characteristics among clients with dementia relative to several comparison groups, as well as clients with other recorded neurological conditions.
Approximately 22% of clients (n=104 802) had a diagnosis of dementia (average age 83 years, 64% female) and about one in four within this group had a co-existing neurological condition (most commonly stroke or Parkinson disease). About 43% of those with dementia did not live with their primary caregiver. Relative to several comparison groups, clients with dementia showed considerably higher levels of cognitive and functional impairment, aggression, anxiety, wandering, hallucinations/delusions, caregiver distress and a greater risk for institutionalization. Conversely, they showed a lower prevalence of several chronic conditions and lower levels of recent health service use. Depressive symptoms were relatively common in the dementia and other neurological groups.
Clients with co-existing neurological conditions exhibited unique clinical profiles illustrating the need for tailored and flexible home care services and enhanced caregiver assistance programs.
本研究全面总结了安大略省大量以社区为基础的老年痴呆症家庭护理客户（年龄在50岁及以上）的社会人口学、心理社会和健康特征，并研究了同时患有神经系统疾病的患者在这些特征上的差异。
在2003年1月至2010年12月期间，使用居家护理居民评估工具（RAI-HC）对客户进行评估。描述性分析考察了这些特征在老年痴呆症患者相对于几个对照组以及其他有记录的神经系统疾病患者中的分布情况。
约22%的客户（n = 104802）被诊断患有老年痴呆症（平均年龄83岁，64%为女性），该组中约四分之一的人同时患有神经系统疾病（最常见的是中风或帕金森病）。约43%的老年痴呆症患者没有与他们的主要照顾者住在一起。相对于几个对照组，老年痴呆症患者表现出更高水平的认知和功能障碍、攻击性、焦虑、徘徊、幻觉/妄想、照顾者困扰以及更高的机构化风险。相反，他们几种慢性病的患病率较低，近期医疗服务使用率也较低。抑郁症状在老年痴呆症组和其他神经系统疾病组中相对常见。
同时患有神经系统疾病的患者表现出独特的临床特征，这表明需要提供量身定制的灵活居家护理服务和强化照顾者援助计划。
