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阿尔茨海默病患者的神经精神症状与照料者负担:TEAM-AD退伍军人事务部合作研究

Neuropsychiatric Symptoms and Caregiver Burden in Individuals With Alzheimer's Disease: The TEAM-AD VA Cooperative Study.

作者信息

Chen Peijun, Guarino Peter D, Dysken Maurice W, Pallaki Muralidhar, Asthana Sanjay, Llorente Maria D, Love Susan, Vertrees Julia E, Schellenberg Gerard D, Sano Mary

机构信息

1 Department of Psychiatry, VISN 10 GRECC, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.

2 Department of Psychiatry, Geriatric Psychiatry Division, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

出版信息

J Geriatr Psychiatry Neurol. 2018 Jul;31(4):177-185. doi: 10.1177/0891988718783897. Epub 2018 Jul 2.

Abstract

OBJECTIVES

To assess the prevalence of neuropsychiatric symptoms (NPS) in mild-to-moderate Alzheimer disease (AD) and their association with caregiver burden.

METHODS

Secondary analyses of baseline data from the Trial of Vitamin E and Memantine in Alzheimer's Disease (TEAM-AD) (N=613). Neuropsychiatric Inventory were used to measure severity of NPS and caregiver activity survey to measure caregiver burden.

RESULTS

A total of 87% of patients displayed at least 1 NPS; 70% displayed clinically meaningful NPS. The most common symptoms were apathy (47%), irritability (44%), agitation (42%), and depression (40%). Those with moderate AD had more severe NPS than those with mild AD ( P = .03). Neuropsychiatric symptoms were significantly associated with caregiver time after adjusting for age, education, cognitive function, and comorbidity ( P-value < .0001) with every point increase in NPS associated with a 10-minute increase in caregiver time.

CONCLUSION

Neuropsychiatric symptoms were prevalent in both mild and moderate AD, even in patients receiving treatment with an acetylcholinesterase inhibitors, and were more severe in moderate AD and associated with greater caregiver time.

摘要

目的

评估轻至中度阿尔茨海默病(AD)患者神经精神症状(NPS)的患病率及其与照料者负担的关联。

方法

对阿尔茨海默病维生素E与美金刚试验(TEAM-AD)(N = 613)的基线数据进行二次分析。使用神经精神科问卷来测量NPS的严重程度,并通过照料者活动调查来测量照料者负担。

结果

共有87%的患者至少表现出1种NPS;70%表现出具有临床意义的NPS。最常见的症状是淡漠(47%)、易怒(44%)、激越(42%)和抑郁(40%)。中度AD患者的NPS比轻度AD患者更严重(P = .03)。在调整年龄、教育程度、认知功能和合并症后,神经精神症状与照料者时间显著相关(P值 < .0001),NPS每增加1分,照料者时间增加10分钟。

结论

神经精神症状在轻度和中度AD患者中均很普遍,即使是接受乙酰胆碱酯酶抑制剂治疗的患者,且在中度AD中更严重,并与更长的照料者时间相关。

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