痴呆症养老院中的资源使用与疾病进程(REDIC-NH),一项纵向队列研究;挪威养老院入院时的设计与患者特征

Resourse Use and Disease Couse in dementia - Nursing Home (REDIC-NH), a longitudinal cohort study; design and patient characteristics at admission to Norwegian nursing homes.

作者信息

Røen Irene, Selbæk Geir, Kirkevold Øyvind, Engedal Knut, Testad Ingelin, Bergh Sverre

机构信息

Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway.

Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.

出版信息

BMC Health Serv Res. 2017 May 22;17(1):365. doi: 10.1186/s12913-017-2289-x.

Abstract

BACKGROUND

Earlier studies of nursing home patients show a high prevalence of dementia, neuropsychiatric symptoms (NPS), pain, and dependency in activities of daily living. The REDIC-NH cohort was set up to study the disease course and the resources used in patients with dementia in Norway. The aim of this paper was to describe the methods and the data collection, and to present selected data about patients at admission to a nursing home.

METHODS

We included 696 patients at admission to a nursing home and followed them with biannual assessments until death. Baseline data were collected between March 2012 and November 2014. In October 2016, patients had either completed an 18-month follow-up (n = 349), passed 18 months without assessments (n = 22), or left the study (n = 324). Data on demographics, cognition, NPS, activities of daily living (ADL) functioning, physical health, medication, Quality of Life (QoL), resource use, and caregiver burden, in addition to DNA samples were collected.

RESULTS

Mean age of the participants at inclusion was 84.5 years (SD 7.5, range 50 - 105), 63.9% were women. According to data collected in the study, 83.8% had dementia, but only 55.9% of them had a diagnosis of dementia registered in their records. The most frequent dementia diagnosis was Alzheimer's disease, which was present in 71% of those with dementia. Patients with dementia more often experienced delusions, hallucinations, agitation, anxiety, disinhibition, irritability, and aberrant motor behaviour compared to patients without dementia. Depression and anxiety were the most common NPS symptoms.

CONCLUSIONS

Dementia and NPS were highly prevalent among persons admitted to nursing homes. Only 55.9% of the patients with dementia had a diagnosis of dementia registered in their records.

摘要

背景

早期针对养老院患者的研究表明,痴呆症、神经精神症状(NPS)、疼痛以及日常生活活动依赖的患病率很高。REDIC-NH队列研究旨在探究挪威痴呆症患者的疾病进程及资源使用情况。本文的目的是描述研究方法和数据收集过程,并呈现养老院入院患者的部分选定数据。

方法

我们纳入了696名养老院入院患者,并每半年进行一次评估直至其死亡。基线数据收集于2012年3月至2014年11月期间。2016年10月,患者要么完成了18个月的随访(n = 349),要么在无评估的情况下度过了18个月(n = 22),要么退出了研究(n = 324)。除了DNA样本外,还收集了有关人口统计学、认知、NPS、日常生活活动(ADL)功能、身体健康、用药、生活质量(QoL)、资源使用以及照顾者负担的数据。

结果

纳入研究时参与者的平均年龄为84.5岁(标准差7.5,范围50 - 105岁),63.9%为女性。根据研究收集的数据,83.8%的患者患有痴呆症,但其中只有55.9%在其记录中有痴呆症诊断。最常见的痴呆症诊断是阿尔茨海默病,在患有痴呆症的患者中占71%。与无痴呆症的患者相比,痴呆症患者更常出现妄想、幻觉、激越、焦虑、脱抑制、易怒和异常运动行为。抑郁和焦虑是最常见的NPS症状。

结论

痴呆症和NPS在养老院入院人群中高度流行。只有55.9%的痴呆症患者在其记录中有痴呆症诊断。

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