INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France.
Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France.
J Am Geriatr Soc. 2020 Jan;68(1):180-185. doi: 10.1111/jgs.16234. Epub 2019 Nov 4.
Neuropsychiatric symptoms are common in dementia. Limited data are available concerning their association with dementia in developing countries. Our aim was to describe the severity of neuropsychiatric symptoms among older people, evaluate the distress experienced by caregivers, and assess which neuropsychiatric symptoms were specifically associated with dementia among older adults in Central Africa.
This study is part of the EPIDEMCA program, a cross-sectional multicenter population-based study.
The EPIDEMCA program was conducted from November 2011 to December 2012 in urban and rural areas of the Central African Republic and the Republic of the Congo.
Participants were older people (≥65 y) included in the EPIDEMCA program who underwent a neuropsychiatric evaluation. The sample included overall 532 participants, of whom 130 participants had dementia.
Neuropsychiatric symptoms were assessed with the brief version of the Neuropsychiatric Inventory including the evaluation of severity and associated distress. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision, criteria were followed to diagnose dementia. A logistic regression model was used to identify associated neuropsychiatric symptoms.
The prevalence of neuropsychiatric symptoms was 89.9% (95% confidence interval = 84.6-95.1) among people living with dementia. The overall median severity score for neuropsychiatric symptoms was 9 [interquartile range [IQR] = 6-12], and the overall median distress score was 7 [IQR = 4-10]. Overall median scores of both severity and distress were significantly increased with the number of neuropsychiatric symptoms, the presence of dementia, and dementia severity. Depression, delusions, apathy, disinhibition, and aberrant motor behavior were associated with dementia after multivariate analysis.
This report is one of the few population-based studies on neuropsychiatric symptoms among older people with dementia in Sub-Saharan Africa and the first one evaluating the severity of those symptoms and distress experienced by caregivers. Individual neuropsychiatric symptoms were strongly associated with dementia in older people and require great attention considering their burden on populations. J Am Geriatr Soc 68:180-185, 2019.
神经精神症状在痴呆中很常见。有关发展中国家痴呆患者神经精神症状的相关数据有限。我们的目的是描述中老年人神经精神症状的严重程度，评估照料者的痛苦程度，并评估哪些神经精神症状与中非老年人的痴呆症有特定关联。
这项研究是 EPIDEMCA 计划的一部分，是一项横断面多中心基于人群的研究。
EPIDEMCA 计划于 2011 年 11 月至 2012 年 12 月在中非共和国和刚果共和国的城乡地区进行。
参加 EPIDEMCA 计划并接受神经精神评估的老年人（≥65 岁）。该样本共包括 532 名参与者，其中 130 名参与者患有痴呆症。
使用简短的神经精神病学评估量表（包括严重程度和相关痛苦的评估）评估神经精神症状。遵循精神障碍诊断与统计手册，第 4 版，文字修订版的标准诊断痴呆症。使用逻辑回归模型确定相关的神经精神症状。
患有痴呆症的患者中神经精神症状的患病率为 89.9%（95%置信区间=84.6-95.1）。神经精神症状的总体中位数严重程度评分为 9 分[四分位距（IQR）=6-12]，总体中位数痛苦评分为 7 分[IQR=4-10]。严重程度和痛苦的中位数总分均随着神经精神症状的数量、痴呆的存在和痴呆的严重程度的增加而显著增加。在多变量分析后，抑郁、妄想、淡漠、失抑制和异常运动行为与痴呆相关。
这是关于撒哈拉以南非洲地区老年人痴呆症患者神经精神症状的少数基于人群的研究之一，也是评估这些症状严重程度和照料者痛苦程度的第一项研究。个体神经精神症状与老年人的痴呆症密切相关，考虑到其对人群的负担，需要引起极大的关注。美国老年医学会 68:180-185,2019。
