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社区居住的老年痴呆症患者中抑郁与徘徊行为之间的关系。

A Relationship between Depression and Wandering in Community-Dwelling Elders with Dementia.

作者信息

Jeong Jae Gwon, Song Jun Ah, Park Kun Woo

机构信息

College of Medicine, Korea University, Seoul, Korea.

College of Nursing, Korea University, Seoul, Korea.

出版信息

Dement Neurocogn Disord. 2016 Mar;15(1):1-6. doi: 10.12779/dnd.2016.15.1.1. Epub 2016 Mar 31.

DOI:10.12779/dnd.2016.15.1.1
PMID:30906332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6427960/
Abstract

BACKGROUND AND PURPOSE

Wandering is one of the most common behavioral and psychological symptoms of dementia, and associated with some of the adverse outcomes in dementia, such as getting lost or even death. The etiology of wandering is not yet clearly known. As depression and wandering are both very common among the patients with dementia, this study examined the relationship between the depression and wandering among the community dwelling patients with dementia.

METHODS

Fifty community dwelling patients diagnosed with dementia were included in this study if they had primary family caregiver, older than age 18 in Seoul, South Korea. The Geriatric Depression Scale, Korean Version (GDS-K), Korean Version of the Mini-Mental State Examination (K-MMSE) and Korean Version of Revised Algase Wandering Scale-Community Version (K-RAWS-CV) were used to measure the severity of depression, cognitive function and wandering.

RESULTS

Thirty percents of the patients showed wandering. Mean score of GDS-K was significantly higher in wanderers than non-wanderers. Severity of depression was significantly correlated with the total score of K-RAWS-CV and subscales of persistent walking, repetitive walking, eloping behavior, and mealtime impulsivity in whole sample. K-MMSE score also was related to wandering behavior. The prevalence odds ratio for wandering in depressed patients compared with undepressed group was 8.386 (95% confidence interval: 1.978-35.561).

CONCLUSIONS

This study implicates that not only cognitive impairment but also psychosocial aspects should be considered in wandering patients with dementia and suggests assessing the depression in patients would be helpful in identifying the causes of wandering.

摘要

背景与目的

徘徊是痴呆症最常见的行为和心理症状之一,与痴呆症的一些不良后果相关,如迷路甚至死亡。徘徊的病因尚不清楚。由于抑郁症和徘徊在痴呆症患者中都很常见,本研究探讨了社区居住的痴呆症患者中抑郁症与徘徊之间的关系。

方法

本研究纳入了50名居住在韩国首尔的社区痴呆症患者,这些患者均有主要家庭照顾者,年龄超过18岁。采用韩国版老年抑郁量表(GDS-K)、韩国版简易精神状态检查表(K-MMSE)和韩国版修订的阿尔加斯徘徊量表社区版(K-RAWS-CV)来测量抑郁严重程度、认知功能和徘徊情况。

结果

30%的患者出现徘徊现象。徘徊者的GDS-K平均得分显著高于非徘徊者。在整个样本中,抑郁严重程度与K-RAWS-CV总分以及持续行走、重复行走、私奔行为和进餐时冲动性等子量表显著相关。K-MMSE得分也与徘徊行为有关。与非抑郁组相比,抑郁患者徘徊的患病率比值比为8.386(95%置信区间:1.978 - 35.561)。

结论

本研究表明,对于患有痴呆症且有徘徊症状的患者,不仅应考虑认知障碍,还应考虑心理社会因素,并建议评估患者的抑郁情况有助于确定徘徊的原因。

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本文引用的文献

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Emotional intervention strategies for dementia-related behavior: a theory synthesis.痴呆相关行为的情绪干预策略:一项理论综述
J Neurosci Nurs. 2008 Apr;40(2):106-15. doi: 10.1097/01376517-200804000-00010.
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[Wandering behavior in Korean elders with dementia residing in nursing homes].[居住在养老院的韩国老年痴呆症患者的徘徊行为]
Taehan Kanho Hakhoe Chi. 2008 Feb;38(1):29-38. doi: 10.4040/jkan.2008.38.1.29.
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Mapping the maze of terms and definitions in dementia-related wandering.梳理痴呆症相关徘徊行为中的术语和定义迷宫。
痴呆症(BPSD)行为和心理症状的建模和移动家庭监测。
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J Am Geriatr Soc. 2007 May;55(5):692-9. doi: 10.1111/j.1532-5415.2007.01135.x.
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Environmental ambiance as a new window on wandering.环境氛围作为漫游的一扇新窗口。
West J Nurs Res. 2006 Feb;28(1):89-104. doi: 10.1177/0193945905282355.
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Translation and validation of the Revised-Algase Wandering Scale (community version) among Korean elders with dementia.修订版阿尔加西游荡量表(社区版)在韩国老年痴呆症患者中的翻译与验证
Aging Ment Health. 2006 Mar;10(2):143-50. doi: 10.1080/13607860600609058.
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A comparison of wandering behavior in nursing homes and assisted living facilities.养老院和辅助生活设施中徘徊行为的比较。
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Dangerous wandering: elopements of older adults with dementia from long-term care facilities.危险的走失:老年痴呆患者从长期护理机构走失
Am J Alzheimers Dis Other Demen. 2004 Nov-Dec;19(6):361-8. doi: 10.1177/153331750401900602.
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Ethnic differences in the prevalence and pattern of dementia-related behaviors.痴呆相关行为的患病率及模式中的种族差异。
J Am Geriatr Soc. 2004 Aug;52(8):1277-83. doi: 10.1111/j.1532-5415.2004.52356.x.
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