Teri L, Larson E B, Reifler B V
Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle 98195.
J Am Geriatr Soc. 1988 Jan;36(1):1-6. doi: 10.1111/j.1532-5415.1988.tb03426.x.
Behavioral problems are thought to be pervasive and devastating to patients with dementia of the Alzheimer's type and their families. Despite this, little empirical data are available concerning the nature of such impairments, their rate of occurrence or their relationship to the disease process. This study investigated 127 patients with a primary diagnosis of dementia of the Alzheimer's type. Two methods of behavioral assessment were employed: a standardized dementia rating scale and a checklist of behavioral problems. Results indicated a) the overall number of problems significantly increased with increased cognitive impairment, b) the types of problems reported varied with cognitive severity, and c) behavioral problems were not significantly associated with patient's age, gender, duration, or age at onset of dementia. These findings are discussed as they relate to the phenomenology of dementia of the Alzheimer's type and to suggestions for interventions at different stages of the disease process. Problems found associated with level of impairment such as wandering, agitation, incontinence, and poor personal hygiene are thought to be characteristic of the disease and therefore predictable. Problems found not associated with level of impairment such as hallucinations, irrational suspicions, falls, and restlessness are likely to be idiosyncratic. The former should probably be incorporated into education and intervention programs; the latter addressed as needed on an individual basis.
行为问题被认为在阿尔茨海默型痴呆患者及其家庭中普遍存在且具有破坏性。尽管如此，关于此类障碍的性质、发生率或其与疾病进程的关系，几乎没有实证数据。本研究调查了127例初步诊断为阿尔茨海默型痴呆的患者。采用了两种行为评估方法：标准化痴呆评定量表和行为问题清单。结果表明：a）随着认知障碍的加重，问题的总数显著增加；b）报告的问题类型随认知严重程度而变化；c）行为问题与患者的年龄、性别、病程或痴呆发病年龄无显著关联。讨论了这些发现与阿尔茨海默型痴呆现象学的关系以及疾病进程不同阶段的干预建议。发现与损害程度相关的问题，如徘徊、激越、失禁和个人卫生差，被认为是该疾病的特征，因此是可预测的。发现与损害程度无关的问题，如幻觉、无端猜疑、跌倒和坐立不安，可能是因人而异的。前者可能应纳入教育和干预项目；后者应根据个体情况按需处理。
