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痴呆症患者在挪威养老院中的焦虑状况:一项为期 12 个月的随访研究。

The course of anxiety in persons with dementia in Norwegian nursing homes: A 12-month follow-up study.

机构信息

Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Pb 68, Ottestad 2312, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway; Department of Nursing Science, Institute of Health and Society, University of Oslo, Pb 1130, Blindern, OSLO 0318, Norway.

Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Pb 68, Ottestad 2312, Norway; Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Pb 2136, Tønsberg 3103, Norway.

出版信息

J Affect Disord. 2018 Aug 1;235:117-123. doi: 10.1016/j.jad.2018.04.015. Epub 2018 Apr 6.

Abstract

BACKGROUND

Knowledge is scarce about the course of anxiety in persons with dementia (PWD) in nursing homes. This study aimed to describe the course of anxiety, anxiety symptoms, and the correlates of change in the Norwegian version of the Rating Anxiety in Dementia scale (RAID-N) score in PWD in nursing homes.

METHODS

Using the RAID-N, anxiety was assessed in 298 PWD aged 65 years and above from 17 Norwegian nursing homes. The assessments were made at baseline and after a mean follow-up period of 350 days (SD 12.3). Associations between the change in RAID-N score and demographic and clinical characteristics were analyzed with multilevel regression models.

RESULTS

At 12 months, 93 participants (31.2%) had died. There was no significant change in the proportion of participants with anxiety, defined as RAID-N score ≥12, from baseline (33.7%) to follow-up (31.2%) (McNemar, p = 0.597). "Motor tension", "frightened and anxious", and "irritability" were the most frequent anxiety symptoms among those with dementia and anxiety. A higher Neuropsychiatric Inventory-Questionnaire (NPI-Q) sub-syndrome affective baseline score and more use of anxiolytics were associated with reduction in RAID-N score, whereas a higher NPI-Q sub-syndrome aroused baseline score and more use of antipsychotics were associated with an increase in RAID-N score at follow-up.

LIMITATIONS

The study did not control for ongoing treatment or changes of comorbidities.

CONCLUSIONS

Anxiety and anxiety symptoms are highly prevalent among PWD in nursing homes over a12-month period. The symptoms "motor tension", "frightened and anxious", and "irritability" require attention in screening for anxiety.

摘要

背景

关于养老院中痴呆患者(PWD)焦虑的病程知之甚少。本研究旨在描述焦虑的病程、焦虑症状以及挪威版痴呆症焦虑评定量表(RAID-N)评分变化的相关性,该评分在养老院中的 PWD 中使用。

方法

使用 RAID-N,对来自 17 家挪威养老院的 298 名年龄在 65 岁及以上的 PWD 进行了焦虑评估。评估在基线和平均 350 天(SD 12.3)的随访期进行。使用多级回归模型分析 RAID-N 评分变化与人口统计学和临床特征之间的关联。

结果

在 12 个月时,93 名参与者(31.2%)死亡。从基线(33.7%)到随访(31.2%),有焦虑症(RAID-N 评分≥12)的参与者比例没有显著变化(McNemar,p=0.597)。“运动紧张”、“恐惧和焦虑”和“易怒”是痴呆症伴焦虑患者最常见的焦虑症状。神经精神病学问卷-问卷(NPI-Q)子综合征情感基线评分较高且使用更多的抗焦虑药与 RAID-N 评分降低相关,而 NPI-Q 子综合征唤醒基线评分较高且使用更多的抗精神病药与随访时 RAID-N 评分增加相关。

局限性

该研究未控制正在进行的治疗或共病的变化。

结论

在 12 个月的时间里,养老院中的 PWD 中焦虑和焦虑症状非常普遍。症状“运动紧张”、“恐惧和焦虑”和“易怒”在筛查焦虑症时需要注意。

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