Jeong Jae Gwon, Song Jun Ah, Park Kun Woo
College of Medicine, Korea University, Seoul, Korea.
College of Nursing, Korea University, Seoul, Korea.
Dement Neurocogn Disord. 2016 Mar;15(1):1-6. doi: 10.12779/dnd.2016.15.1.1. Epub 2016 Mar 31.
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.
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.
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).
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.
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。
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。
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)。
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。