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痴呆症护理中延迟寻求帮助行为:中国阿尔茨海默病临床路径(CPAD)研究的初步结果

Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study.

作者信息

Zhao Mei, Lv Xiaozhen, Tuerxun Maimaitirexiati, He Jincai, Luo Benyan, Chen Wei, Wang Kai, Gu Ping, Kuang Weihong, Zhou Yuying, Qu Qiumin, He Jianhua, Zhang Nan, Feng Yongping, Wang Yanping, Yu Xin, Wang Huali

机构信息

Dementia Care & Research Center,Peking University Institute of Mental Health (Sixth Hospital);Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia,Beijing 100191,China.

Department of Neurology,The First Affiliated Hospital,Wenzhou Medical College,Wenzhou 325000,Zhejiang Province,China.

出版信息

Int Psychogeriatr. 2016 Feb;28(2):211-9. doi: 10.1017/S1041610215000940. Epub 2015 Jul 3.

Abstract

BACKGROUND

The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.

METHODS

Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.

RESULTS

The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p = 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p < 0.001). Subtypes of dementia (p < 0.001), family history (p = 0.01), and education level (p = 0.03) were associated with the increased delay in help seeking.

CONCLUSIONS

In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.

摘要

背景

在中国,痴呆症患者寻求帮助延迟的患病率及相关因素尚不清楚。

方法

在中国阿尔茨海默病临床路径研究(CPAD研究,NCT01779310)中连续登记的1010名参与者中,576名痴呆症患者(PWDs)及其 informant 报告了从症状出现到首次寻求诊断的医疗就诊估计时间。使用一般线性模型的单变量分析来检查与延迟寻求诊断相关的潜在因素。

结果

从首次出现明显症状到首次寻求诊断或治疗的中位持续时间为1.77年。有痴呆症家族史阳性的个体持续时间更长(p = 0.05)。与其他类型的痴呆症相比,血管性痴呆(VaD)患者最早被转诊进行诊断,这种延迟的顺序为:VaD < 阿尔茨海默病(AD)< 额颞叶痴呆(FTD)(p < 0.001)。痴呆症亚型(p < 0.001)、家族史(p = 0.01)和教育水平(p = 0.03)与寻求帮助的延迟增加有关。

结论

在中国,即使在成熟的记忆诊所,痴呆症患者寻求诊断也会延迟约2年。临床特征、家族史和较低的教育水平可能会阻碍痴呆症护理中的求助行为。

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