Livingston Gill, Barber Julie, Marston Louise, Rapaport Penny, Livingston Deborah, Cousins Sian, Robertson Sarah, La Frenais Francesca, Cooper Claudia
, MD, Department of Old Age Psychiatry, Division of Psychiatry, UCL, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
, PhD, Department of Statistical Science, UCL, London, UK.
BJPsych Open. 2017 Jul 27;3(4):171-178. doi: 10.1192/bjpo.bp.117.005181. eCollection 2017 Jul.
Agitation is reportedly the most common neuropsychiatric symptom in care home residents with dementia.
To report, in a large care home survey, prevalence and determinants of agitation in residents with dementia.
We interviewed staff from 86 care homes between 13 January 2014 and 12 November 2015 about residents with dementia with respect to agitation (Cohen-Mansfield Agitation Inventory (CMAI)), quality of life (DEMQOL-proxy) and dementia severity (Clinical Dementia Rating). We also interviewed residents and their relatives. We used random effects models adjusted for resident age, gender, dementia severity and care home type with CMAI as a continuous score.
Out of 3053 (86.2%) residents who had dementia, 1489 (52.7%) eligible residents participated. Fifteen per cent of residents with very mild dementia had clinically significant agitation compared with 33% with mild (odds ratios (ORs)=4.49 95% confidence interval (CI)=2.30) and 45% with moderate or severe dementia (OR=6.95 95% CI=3.63, 13.31 and OR=6.23 95% CI=3.25, 11.94, respectively). More agitation was associated with lower quality of life (regression coefficient (rc)=-0.53; 95% CI=-0.61, -0.46) but not with staffing or resident ratio (rc=0.03; 95% CI=-0.04, 0.11), level of residents' engagement in home activities (rc=3.21; 95% CI=-0.82, 7.21) or family visit numbers (rc=-0.03; 95% CI=-0.15, 0.08). It was correlated with antipsychotic use (rc=6.45; 95% CI=3.98, 8.91).
Care home residents with dementia and agitation have lower quality of life. More staffing time and activities as currently provided are not associated with lower agitation levels. New approaches to develop staff skills in understanding and responding to the underlying reasons for individual resident's agitation require development and testing.
None.
© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
据报道，激越行为是痴呆症护理院居民中最常见的神经精神症状。
在一项大型护理院调查中，报告痴呆症患者激越行为的患病率及其决定因素。
在2014年1月13日至2015年11月12日期间，我们就痴呆症患者的激越行为（科恩-曼斯菲尔德激越量表（CMAI））、生活质量（DEMQOL代理版）和痴呆严重程度（临床痴呆评定量表），对86家护理院的工作人员进行了访谈。我们还对居民及其亲属进行了访谈。我们使用随机效应模型，针对居民年龄、性别、痴呆严重程度和护理院类型进行了调整，将CMAI作为连续评分。
在3053名（86.2%）患有痴呆症的居民中，1489名（52.7%）符合条件的居民参与了调查。15%的极轻度痴呆患者有临床上显著的激越行为，相比之下，轻度痴呆患者为33%（优势比（OR）=4.49，95%置信区间（CI）=2.30），中度或重度痴呆患者为45%（OR=6.95，95%CI=3.63，13.31；OR=6.23，95%CI=3.25，11.94）。激越行为越多与生活质量越低相关（回归系数（rc）=-0.53；95%CI=-0.61，-0.46），但与工作人员配备或居民比例无关（rc=0.03；95%CI=-0.04，0.11），与居民参与家庭活动的程度无关（rc=3.21；95%CI=-0.82，7.21），也与家庭探访次数无关（rc=-0.03；95%CI=-0.15，0.08）。它与抗精神病药物的使用相关（rc=6.45；95%CI=3.98，8.91）。
患有痴呆症且有激越行为的护理院居民生活质量较低。目前提供的更多工作人员时间和活动与较低的激越水平无关。需要开发和测试新的方法来提高工作人员理解和应对居民激越行为根本原因的技能。
无。
©皇家精神病学院2017年。这是一篇开放获取文章，根据知识共享非商业性、无衍生作品（CC BY-NC-ND）许可协议分发。
