Akyol Merve Aliye, Küçükgüçlü Özlem, Yener Görsev
Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey.
Internal Medicine Nursing Doctorate Programme, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
Noro Psikiyatr Ars. 2019 Aug 7;57(2):120-125. doi: 10.29399/npa.22964. eCollection 2020 Jun.
Apathy is an important factor in the clinical management of dementia, as it has been associated with poor disease outcome, reduced daily functioning and caregiver distress. Considering apathy as a problem that needs to be managed and knowing the factors affecting apathy will enable appropriate initiatives to be planned. This study was conducted to compare apathy across three types of dementia and determine the factors affecting apathy for each of the three types of dementia.
The sample consisted of 46 patients with Alzheimer's disease (AD), 31 patients with frontotemporal dementia (FTD) and 29 patients with vascular dementia (VaD). Apathy was assessed using the Neuropsychiatric Inventory-apathy subscale (NPI), dementia severity was assessed using the Clinical Dementia Rating Scale (CDR), cognitive status was assessed using the Mini Mental Status Examination (MMSE) functional ability was measured with the Katz Index of Independence in Activities of Daily Living (ADL) and the Lawton-Brody Instrumental Activities of Daily Living (IADL). This is a descriptive and cross-sectional study.
Significant differences were found between the apathy score of three types of dementia. Cognitive impairment correlated significantly with the apathy score in AD and VaD. Functionality scores and severity of dementia showed a significant correlation with apathy in each group. No statistically significant relationship was detected between age, gender and apathy. Multiple regression analyses show that apathy scores correlated with IADL in patients with AD.
This study demonstrated that apathy is very common symptom in patients with FTD as well as patients with AD and VaD. Health professionals need to be aware of recognize apathy. Patients should be assessed for apathy regardless of dementia types, age and gender.
冷漠是痴呆临床管理中的一个重要因素，因为它与不良的疾病预后、日常功能减退及照料者痛苦相关。将冷漠视为一个需要管理的问题并了解影响冷漠的因素，将有助于制定适当的应对措施。本研究旨在比较三种类型痴呆患者的冷漠情况，并确定每种类型痴呆中影响冷漠的因素。
样本包括46例阿尔茨海默病（AD）患者、31例额颞叶痴呆（FTD）患者和29例血管性痴呆（VaD）患者。使用神经精神科问卷-冷漠分量表（NPI）评估冷漠情况，使用临床痴呆评定量表（CDR）评估痴呆严重程度，使用简易精神状态检查表（MMSE）评估认知状态，使用日常生活活动能力的Katz独立指数（ADL）和洛顿-布罗迪日常生活活动能力量表（IADL）测量功能能力。这是一项描述性横断面研究。
发现三种类型痴呆的冷漠得分存在显著差异。AD和VaD患者的认知障碍与冷漠得分显著相关。每组患者的功能得分和痴呆严重程度与冷漠显著相关。未检测到年龄、性别与冷漠之间存在统计学显著关系。多元回归分析显示，AD患者的冷漠得分与IADL相关。
本研究表明，冷漠在FTD患者以及AD和VaD患者中是非常常见的症状。卫生专业人员需要意识到并识别冷漠。无论痴呆类型、年龄和性别如何，都应对患者进行冷漠评估。
