Sun Meng, Mainland Brian J, Ornstein Tisha J, Mallya Sasha, Fiocco Alexandra J, Sin Gwen Li, Shulman Kenneth I, Herrmann Nathan
Department of Psychiatry, The Second Xianga Hospital, Central South University; National Clinical Research Center on Mental Health Disorders (Xiangya); National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan; Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, China.
Division of Geriatric Psychiatry, Department of Psychiatry, Sunnybrook Health Sciences Centre; Department of Psychiatry, University of Toronto, Canada.
Int J Geriatr Psychiatry. 2018 Feb;33(2):e280-e285. doi: 10.1002/gps.4788. Epub 2017 Sep 22.
OBJECTIVE: Cognitive fluctuations (CFs) occur commonly in dementia of all types. While it is generally accepted that CFs can affect the clinical rating of dementia severity and neuropsychological performance, little is known about their impact on patients' activities of daily living (ADLs) and quality of life (QOL). Our study aims to explore the impact of CFs on ADLs and QOL among institutionalized patients with dementia. METHODS: The present study examined the nature and frequency of CFs in 55 institutionalized dementia patients. We used the Dementia Cognitive Fluctuation Scale (DCFS) to assess the presence and severity of CFs. The Alzheimer's Disease Functional Assessment of Change Scale (ADFACS) was used to assess patients' ADLs, and the Quality of Life in Late Stage Dementia scale (QUALID) was used to assess QOL. Linear regression models were used to assess the relationships between CFs, ADLs, and QOL. RESULTS: The mean age of the patients was 90.41 years (SD = 2.84). Their mean Aggressive Behavior Scale score was 1.13 (SD = 1.59), mean Severe Impairment Battery total score was 86.65 (SD = 13.77), and mean DCFS score was 10.07 (SD = 3.04). The mean ADFACS-ADL score was 10.88 (SD = 6.37), mean ADFACS-IADL score was 16.61 (SD = 9.54), and mean QUALID total score was 18.25 (SD = 5.70). DCFS significantly predicted ADFACS-ADL score (R = 0.39, β = 0.30, P = .011) although the relationship between ADFACS-IADL score and DCFS score was not significant (R = 0.16, P = .111). DCFS significantly predicted QUALID score (R = 0.08, β = 0.29, P = .033). CONCLUSION: More severe CFs in patients with dementia were significantly associated with impaired ability to engage in ADLs and poorer QOL.
目的：认知波动（CFs）在所有类型的痴呆症中都很常见。虽然人们普遍认为认知波动会影响痴呆严重程度的临床评分和神经心理表现，但对于它们对患者日常生活活动（ADLs）和生活质量（QOL）的影响却知之甚少。我们的研究旨在探讨认知波动对机构化痴呆患者日常生活活动和生活质量的影响。 方法：本研究调查了55名机构化痴呆患者认知波动的性质和频率。我们使用痴呆认知波动量表（DCFS）来评估认知波动的存在和严重程度。阿尔茨海默病功能变化评估量表（ADFACS）用于评估患者的日常生活活动，晚期痴呆生活质量量表（QUALID）用于评估生活质量。线性回归模型用于评估认知波动、日常生活活动和生活质量之间的关系。 结果：患者的平均年龄为90.41岁（标准差=2.84）。他们的攻击行为量表平均得分为1.13（标准差=1.59），严重损害成套测验总分平均为86.65（标准差=13.77），DCFS平均得分为10.07（标准差=3.04）。ADFACS-ADL平均得分为10.88（标准差=6.37），ADFACS-IADL平均得分为16.61（标准差=9.54），QUALID总分平均为18.25（标准差=5.70）。DCFS显著预测ADFACS-ADL得分（R = 0.39，β = 0.30，P = 0.011），尽管ADFACS-IADL得分与DCFS得分之间的关系不显著（R = 0.16，P = 0.111）。DCFS显著预测QUALID得分（R = 0.08，β = 0.29，P = 0.033）。 结论：痴呆患者更严重的认知波动与日常生活活动能力受损和较差的生活质量显著相关。
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