阿尔茨海默病患者行为和心理症状的危险因素：韩国痴呆症临床研究
Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study.
作者信息
Park Sunyoung, Kim Doh Kwan, Myung Woojae, Yoo Jun Hyun, Shin Su Jeong, Na Duk L, Kim Sang Yun, Lee Jae-Hong, Kim Seong Yoon, Han Seol-Heui, Choi Seong Hye, Shin Jinyoung
机构信息
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Korean J Fam Med. 2019 Jan;40(1):16-21. doi: 10.4082/kjfm.17.0061. Epub 2018 Oct 29.
BACKGROUND
Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data.
METHODS
This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted.
RESULTS
The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers.
CONCLUSION
Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.
背景
在对大量患者样本进行的阿尔茨海默病初始评估中，很少有研究评估痴呆行为和心理症状的风险因素。在本研究中，利用韩国痴呆临床研究数据对影响阿尔茨海默病的因素进行了检查。
方法
本横断面研究使用了1128例阿尔茨海默病患者的数据。使用韩语版神经精神科问卷对痴呆的行为和心理症状进行检查。评估了人口统计学特征、健康相关行为、神经心理测试、合并症、血液检查结果和照料者特征。进行了调整协变量的中位数逻辑回归分析。
结果
在调整混杂因素后，痴呆的行为和心理症状与首尔神经心理筛查量表-痴呆中的记忆（P=0.022）和额叶/执行功能（P<0.001）、日常生活活动能力巴氏指数（P<0.001）、韩语版简易精神状态检查表评分（P=0.003）以及照料者年龄（P=0.005）呈负相关，与首尔日常生活工具性活动评分（P<0.001）、临床痴呆评定框总和（P<0.001）、总体衰退量表评分（P<0.001）、游离T4水平异常（P<0.001）、贫血（P<0.001）以及中风家族史（P=0.001）呈正相关。女性照料者照顾的患者比男性照料者照顾的患者表现出更严重的痴呆行为和心理症状。
结论
阿尔茨海默病患者的痴呆行为和心理症状与多种风险因素相关，包括无法独立生活和阿尔茨海默病严重程度。这些发现表明，痴呆行为和心理症状的预防和治疗策略应是综合性的。
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