Gerontological Therapeutic Complex "A Veiga", Serge Lucense, Lugo, Spain.
Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain.
Psychogeriatrics. 2021 May;21(3):272-278. doi: 10.1111/psyg.12659. Epub 2021 Feb 17.
Apathy and agitation are often recognized as the most problematic behavioural and psychological symptoms in care settings. In this study, we analyze the relationship between apathy and agitation symptoms other and their relationship with demographic, cognitive, and neuropsychiatric variables and psychotropic medication use.
A retrospective study was conducted at a gerontological care centre in Láncara, Spain. Participants were 196 residents of the gerontological care centre, including 143 with a diagnosis of dementia. Apathy and agitation were assessed with the Apathy Scale for Institutionalized Patients with Dementia, Nursing Home version, and the Spanish version of the Cohen-Mansfield Agitation Inventory, respectively. Two-stage hierarchical cluster analysis (hierarchical cluster analysis in a first exploratory stage and K-means clustering to obtain the final solution in the second stage) was conducted to assign residents to different groups based on apathy and agitation scores.
In cluster 1, a certain level of apathy, the highest levels of agitation, and the most frequent intake of atypical antipsychotics and clomethiazole were observed. The highest levels of apathy and the most frequent intake of memantine were seen in cluster 2. The lowest levels of agitation and apathy and the highest levels of cognitive performance were found in cluster 3.
In this study, subjects with dementia were in a state of high agitation and eventual apathy, had low cognitive status, and were very old. Patients with this profile require well-designed non-pharmacological interventions.
冷漠和激越通常被认为是护理环境中最具问题的行为和心理症状。在这项研究中，我们分析了冷漠和激越症状之间的关系，以及它们与人口统计学、认知和神经精神变量以及精神药物使用的关系。
这是一项在西班牙兰卡拉的老年护理中心进行的回顾性研究。参与者为老年护理中心的 196 名居民，其中 143 名被诊断为痴呆症。使用痴呆症住院患者淡漠量表（Nursing Home 版）和西班牙版科恩-曼斯菲尔德激越量表分别评估淡漠和激越症状。采用两阶段层次聚类分析（第一阶段探索性层次聚类分析和第二阶段 K-均值聚类分析以获得最终解决方案）根据淡漠和激越评分将居民分配到不同的组中。
在第 1 组中，观察到一定程度的淡漠、最高水平的激越和最频繁使用非典型抗精神病药和氯米噻唑。在第 2 组中，观察到最高水平的淡漠和最频繁使用美金刚。在第 3 组中，观察到最低水平的激越和淡漠以及最高水平的认知表现。
在这项研究中，患有痴呆症的受试者处于高度激越和最终冷漠的状态，认知状态较低，且年龄较大。具有这种特征的患者需要精心设计的非药物干预。
