Portellano-Ortiz Cristina, Turró-Garriga Oriol, Gascón-Bayarri Jordi, Piñán-Hernández Sara, Moreno-Cordón Laura, Viñas-Díez Vanesa, Reñé-Ramírez Ramón, Conde-Sala Josep Lluís
Universitat de Barcelona. Facultat de Psicologia, Barcelona, Espana.
Rev Neurol. 2014 Sep 1;59(5):193-204.
Anosognosia and depression can influence perceptions of the patient's quality of life (QoL-p) in Alzheimer's disease (AD).
To explore changes in perceived QoL-p in AD and the influence that depression and anosognosia can have on both patient and caregiver ratings.
Observational, analytical and longitudinal study over 12 months of a consecutive sample of 221 outpatients. Mean age was 77.8 ± 7.3 years and there were 140 women (63.3%). Instruments: Quality of Life in AD, Anosognosia Questionnaire-Dementia, Geriatric Depression Scale, Disability Assessment for Dementia, Neuropsychiatric Inventory, Mini-Mental State Examination and Global Deterioration Scale. Effect size of the differences between two means was calculated, and a linear regression analysis involving the factors associated with perceived QoL-p was performed.
Patients with anosognosia had less depression and higher scores on the Quality of Life in AD, as compared with patients without anosognosia, and regardless of antidepressant drug treatment. Caregiver ratings of QoL-p were more negative. In the linear regression the largest discrepancies between patient and caregiver ratings of QoL-p were associated with anosognosia, depression, and functional status, factors that explained 35.3, 7.9 and 11.3% of the variance, respectively.
Anosognosia was associated with less depression and better perceived quality of life in patients.
疾病失认症和抑郁症会影响阿尔茨海默病(AD)患者对生活质量的认知(QoL-p)。
探讨AD患者QoL-p认知的变化,以及抑郁症和疾病失认症对患者及照料者评分的影响。
对221名门诊患者进行连续12个月的观察性、分析性纵向研究。平均年龄为77.8±7.3岁,其中女性140名(63.3%)。工具:AD生活质量量表、痴呆症疾病失认症问卷、老年抑郁量表、痴呆症残疾评估量表、神经精神科问卷、简易精神状态检查表和总体衰退量表。计算两个均值之间差异的效应量,并对与QoL-p认知相关的因素进行线性回归分析。
与无疾病失认症的患者相比,无论是否接受抗抑郁药物治疗,患有疾病失认症的患者抑郁程度较轻,AD生活质量量表得分较高。照料者对QoL-p的评分更为负面。在线性回归中,患者和照料者对QoL-p评分的最大差异与疾病失认症、抑郁症和功能状态相关,这些因素分别解释了35.3%、7.9%和11.3%的方差。
疾病失认症与患者抑郁程度较轻和生活质量认知较好相关。