Liao Z L, Chen Y, Tan Y F, Zhu J P, Qiu Y J, Lin S S, Wu M H, Mao Y P, Yu E Y
Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China.
Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China.
Zhonghua Yi Xue Za Zhi. 2019 Feb 19;99(7):532-536. doi: 10.3760/cma.j.issn.0376-2491.2019.07.011.
To compare the differences of cognitive function, daily living ability and neuropsychiatric symptoms in patients with sporadic type of Alzheimer's disease (AD) under different care modes, and find the most favorable care mode for delaying the progress of disease. One hundred and twenty cases of AD patients were divided into three groups: Spouse Care Group, Adult Child Care Group and Nursing Home Group. Medical history collection and scale evaluation were carried out by trained specialists on 3 groups of patients and caregivers. Assessment included socio-demographic data, including name, gender, age, course of the disease, the year of education and the way of care, Mini mental state examination (MMSE), Activity of Daily Living (ADL), Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-Cog), Neuropsychiatric Inventory (NPI), and the Relevant Outcome Scale for Alzheimer's disease (ROSA). All the evaluations were completed upon enrollment. The differences in cognitive function, daily living ability and neuropsychiatric symptoms were compared among the three groups. There was no significant difference in age, gender, education duration and course of disease between the three groups (0.05). The MMSE average scores of Spouse Care Group, Adult Child Care Group and Nursing Home Group were 19±7, 15±6, 13±7 respectively. The ADAS-Cog median scores of Spouse Care Group, Adult Child Care Group and Nursing Home Group were 17.32(9.78, 26.50), 30.00(16.10, 38.55), 33.15 (16.28, 50.68). The NPI median total scores of Spouse Care Group, Adult Child Care Group and Nursing Home Group were 5.00(1.00, 13.00), 9.00(4.00, 20.00), 19.50(8.50, 28.50) respectively. The ADL average scores of Spouse Care Group, Adult Child Care Group and Nursing Home Group were 21±9, 25±9, 35±11. The difference of MMSE, ADAS-Cog, ADL and NPI was statistically significant among the three groups (0.05). No significant difference was found in care burden among the three groups (0.05). The AD patients with spouse care tend to suffer from mild diseases severitys, no matter in terms of cognitive function, daily living ability or neuropsychiatric symptoms. Close, familiar and comprehensive care plays an important role in delaying the progress of AD.
为比较不同照护模式下散发性阿尔茨海默病(AD)患者认知功能、日常生活能力及神经精神症状的差异,探寻最有利于延缓疾病进展的照护模式。将120例AD患者分为三组:配偶照护组、成年子女照护组和养老院照护组。由经过培训的专科医生对三组患者及照护者进行病史采集和量表评估。评估内容包括社会人口学资料,如姓名、性别、年龄、病程、受教育年限及照护方式,简易精神状态检查表(MMSE)、日常生活活动能力(ADL)、阿尔茨海默病评估量表认知部分(ADAS - Cog)、神经精神症状量表(NPI)以及阿尔茨海默病相关结局量表(ROSA)。所有评估均在入组时完成。比较三组患者在认知功能、日常生活能力及神经精神症状方面的差异。三组患者在年龄、性别、受教育年限和病程方面差异无统计学意义(P>0.05)。配偶照护组、成年子女照护组和养老院照护组的MMSE平均得分分别为19±7、15±6、13±7。配偶照护组、成年子女照护组和养老院照护组的ADAS - Cog中位数得分分别为17.32(9.78,26.50)、30.00(16.10,38.55)、33.15(16.28,50.68)。配偶照护组、成年子女照护组和养老院照护组的NPI中位数总分分别为5.00(1.00,13.00)、9.00(4.00,20.00)、19.50(8.50,28.50)。配偶照护组、成年子女照护组和养老院照护组的ADL平均得分分别为21±9、25±9、35±11。三组患者在MMSE、ADAS - Cog、ADL及NPI方面的差异有统计学意义(P<0.05)。三组患者在照护负担方面差异无统计学意义(P>0.05)。无论在认知功能、日常生活能力还是神经精神症状方面,由配偶照护的AD患者疾病严重程度往往较轻。亲密、熟悉且全面的照护对延缓AD进展起着重要作用。