Department of Neurology, KTO University Medical Faculty affiliated Konya Medicana Hospital, Konya, Turkey.
Department of Psychiatry, Private Institution, Konya, Turkey.
J Geriatr Psychiatry Neurol. 2020 Sep;33(5):243-249. doi: 10.1177/0891988719874123. Epub 2019 Sep 16.
We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers' depression, on the caregiver burden.
One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI).
Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( = .009, χ = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( = .000, χ = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( < .05).
The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.
研究阿尔茨海默病（AD）患者不适当性行为（ISB）和神经精神症状（NPS）以及照料者抑郁对照料者负担的影响。
纳入 143 例 AD 患者及其照料者。选择 65 例因残疾需要照顾的非 AD 患者及其照料者作为对照组。采用定式临床访谈（SCID-I）诊断照料者抑郁。采用简易精神状态检查量表（MMSE）和临床痴呆评定量表（CDR）评估 AD 严重程度。采用神经精神问卷（NPI）评估患者的 NPS。采用照料者负担量表（ZBI）评估照料者负担。
AD 组中发现 13 例（9.1%）存在不适当性行为。中重度 AD 患者中不适当性行为更常见（ =.009， χ = 9.396）。AD 组中存在 ISB 的患者照料者中抑郁的发生率（n = 38，26.6%）更高（ =.000， χ = 24.69）。AD 组患者照料者的 ZBI 评分高于对照组。此外，AD 组中存在 ISB、NPI 总分较高和 MMSE 评分较低的患者，其照料者的 ZBI 评分显著较高（ <.05）。存在抑郁的 AD 组患者照料者的 ZBI 评分更高（ <.05）。
AD 的严重程度、患者的 NPS 以及照料者的重度抑郁是增加照料者负担的危险因素。
