Department of Rehabilitation, Fondazione Camplani Casa di Cura "Ancelle della Carità", Via Aselli 16, 26100, Cremona, Italy.
Geriatric Research Group, Brescia, Italy.
Aging Clin Exp Res. 2020 Feb;32(2):339-344. doi: 10.1007/s40520-019-01194-7. Epub 2019 Apr 11.
Delirium superimposed on dementia (DSD) is common and associated with adverse outcomes. Current evidence indicates that some patients with dementia may recall delirium with distress for them and their caregivers. The aim of this study is to identify predictors of distress in informal caregivers of older patient with DSD.
A total of 33 caregivers of 33 patients with DSD were interviewed 3 days after the resolution of delirium (T0) and at 1-month follow-up (T1) to describe their level of distress related to the delirium episode. A linear regression was used to identify predictors of caregivers' distress at T0 and T1 defined a priori: age, sex, level of education, employment status, delirium subtypes, delirium severity, type and severity of dementia, and the time spent with the patient during the delirium episode.
Caregivers were mostly female (81%), 59 (± 13.0) years old on average. The predictors of distress at T0 were the patient's severity of both dementia and delirium. Moderate dementia was associated with lower distress, whereas higher delirium severity was associated with greater distress. At 1-month follow-up, the predictors of distress were the age of caregiver and time spent in care; the distress level was higher when caregivers were older, and they spent less time with their loved one.
These preliminary findings underline the importance of providing continuous training and support for the caregivers, especially in coping strategies, in order to improve the care of DSD patients and prevent the caregivers' distress in long time period.
痴呆并发谵妄(DSD)很常见,且与不良结局相关。目前的证据表明,一些痴呆患者可能会因谵妄而感到痛苦,并因此给他们自己和护理人员带来困扰。本研究旨在确定痴呆并发谵妄老年患者的非专业照护者的困扰预测因素。
共有 33 名 DSD 患者的 33 名非专业照护者在谵妄缓解后 3 天(T0)和 1 个月随访时(T1)接受了访谈,以描述他们与谵妄发作相关的困扰程度。采用线性回归来识别预先定义的 T0 和 T1 时非专业照护者困扰的预测因素:年龄、性别、教育程度、就业状况、谵妄亚型、谵妄严重程度、痴呆类型和严重程度,以及谵妄发作期间与患者在一起的时间。
非专业照护者主要为女性(81%),平均年龄为 59(±13.0)岁。T0 时困扰的预测因素是患者痴呆和谵妄的严重程度。中度痴呆与较低的困扰相关,而较高的谵妄严重程度与更大的困扰相关。在 1 个月随访时,困扰的预测因素是非专业照护者的年龄和照护时间;当非专业照护者年龄较大时,其困扰程度更高,且与他们所爱的人相处的时间更少。
这些初步发现强调了为照护者提供持续培训和支持的重要性,特别是在应对策略方面,以改善 DSD 患者的护理并防止长期困扰照护者。