School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA.
Int J Geriatr Psychiatry. 2018 Jan;33(1):185-192. doi: 10.1002/gps.4705. Epub 2017 Mar 23.
Dementia-related restlessness is commonly endorsed by caregivers but not well understood. This study examines differences in characteristics (demographics, cognitive status, physical function, pain, and mood) of persons with dementia whose caregivers endorse restlessness versus those who do not. We also examine the relationship of restlessness to caregiver well-being including burden, upset with behaviors, mastery, and depressive symptomatology.
We combined baseline data from three caregiver intervention studies of community-dwelling persons with dementia who exhibited neuropsychiatric symptoms (n = 569) as measured by the Agitated Behaviors in Dementia Scale. We conducted bivariate correlations and independent t-tests by using the Agitated Behaviors in Dementia Scale restlessness item.
Nearly 65% (n = 367) of dementia caregivers reported restlessness. There were no significant differences between those with and without (n = 202) reported restlessness concerning functional status (physical or cognitive). However, persons with restlessness had significantly higher pain scores (p < 0.01), were more likely to be on behavioral medications (p < 0.001), and had more neuropsychiatric symptoms as compared with persons without restlessness (M = 11.11, nonrestless; M = 6.61, restless) (p < 0.001). Caregivers of persons with dementia-related restlessness reported greater burden (p < 0.001), behavioral upset (p < 0.001), depression (p < 0.001), and lower mastery providing care (p < 0.01) compared with caregivers of persons without dementia-related restlessness.
Restlessness is a common neuropsychiatric symptom that appears to be associated with poorer functioning in persons with dementia and greater distress in their caregivers. Further research is needed to understand the unique contributions of restlessness to care burden and quality of life of persons with dementia, as well as ways to address this distressing symptom. Copyright © 2017 John Wiley & Sons, Ltd.
与照料者的认知相符,痴呆相关性激越较为常见,但尚未被充分理解。本研究旨在分析激越被照料者报告与未被报告的痴呆患者在特征(人口统计学、认知状态、身体功能、疼痛和情绪)方面的差异。我们还研究了激越与照料者福祉(包括负担、行为困扰、掌控感和抑郁症状)之间的关系。
我们结合了三项针对社区居住的具有神经精神症状(采用痴呆激越行为量表评估)的痴呆患者的照料者干预研究的基线数据(n=569)。我们采用痴呆激越行为量表激越项目进行了二变量相关性分析和独立 t 检验。
近 65%(n=367)的痴呆照料者报告存在激越。激越被报告与未被报告(n=202)的患者在功能状态(身体或认知)方面没有显著差异。然而,激越患者的疼痛评分显著更高(p<0.01),更有可能服用行为药物(p<0.001),并且与无激越患者相比,具有更多的神经精神症状(M=11.11,无激越;M=6.61,激越)(p<0.001)。与无痴呆相关性激越的患者相比,照料者报告有更大的负担(p<0.001)、行为困扰(p<0.001)、抑郁(p<0.001)和较低的照顾掌控感(p<0.01)。
激越是一种常见的神经精神症状,与痴呆患者的功能更差以及照料者的痛苦更大有关。需要进一步研究以了解激越对痴呆患者的照顾负担和生活质量的独特贡献,以及如何解决这种令人痛苦的症状。版权所有 © 2017 约翰威立父子公司。