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孤独感在痴呆患者行为和心理症状中的重要性。

Importance of loneliness in behavioral and psychological symptoms of dementia.

机构信息

Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Graduate School of Human Sciences, Osaka University, Osaka, Japan.

出版信息

Int J Geriatr Psychiatry. 2021 Apr;36(4):540-546. doi: 10.1002/gps.5450. Epub 2020 Oct 29.

Abstract

OBJECTIVES

Loneliness is considered to be a crucial factor in mental health of elderly people. However, the effects of loneliness on behavioral and psychological symptoms of dementia (BPSD) have not been fully examined. The aim of this study was to investigate whether loneliness in patients with dementia is related to BPSD.

METHODS

A total of 152 patients with dementia were assessed using the Neuropsychiatric Inventory (NPI-12) and the revised University of California at Los Angeles (UCLA) loneliness scale. Spearman correlation analysis and Mann-Whitney U-tests were used to examine factors associated with the revised UCLA loneliness scale. Logistic regression analysis with a forced entry method was performed to identify risk factors for BPSD.

RESULTS

The revised UCLA loneliness scale score was not significantly associated with age, years of education, mini-mental state examination (MMSE) score, gender, living status, visual impairment, hearing impairment, and marital status. However, this score was a significant predictor of NPI delusion and hallucination subscale scores and Geriatric Depression Scale-15 score. The MMSE score was a significant predictor of NPI anxiety and apathy subscale scores.

CONCLUSIONS

Loneliness is a risk factor for BPSD, especially for depressive symptoms and psychosis. Paying attention to loneliness in patients with dementia will help medical staff to intervene in psychiatric symptoms of these patients at an early stage.

摘要

目的

孤独被认为是老年人心理健康的一个关键因素。然而,孤独对痴呆患者的行为和心理症状(BPSD)的影响尚未得到充分研究。本研究旨在探讨痴呆患者的孤独感是否与 BPSD 有关。

方法

共对 152 例痴呆患者进行了神经精神病学问卷(NPI-12)和加利福尼亚大学洛杉矶分校(UCLA)孤独量表修订版的评估。采用 Spearman 相关分析和 Mann-Whitney U 检验对与 UCLA 孤独量表修订版相关的因素进行了分析。采用强制进入法的 Logistic 回归分析确定 BPSD 的危险因素。

结果

UCLA 孤独量表修订版评分与年龄、受教育年限、简易精神状态检查(MMSE)评分、性别、居住状况、视力障碍、听力障碍和婚姻状况无显著相关性。然而,该评分是 NPI 妄想和幻觉子量表评分和老年抑郁量表-15 评分的显著预测因子。MMSE 评分是 NPI 焦虑和淡漠子量表评分的显著预测因子。

结论

孤独是 BPSD 的一个危险因素,尤其是对抑郁症状和精神病。关注痴呆患者的孤独感将有助于医务人员在早期干预这些患者的精神症状。

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