Tokyo Metropolitan Institute of Gerontology Research Team for Human Care, Itabashi-ku, Tokyo, Japan.
Tokyo Metropolitan Institute of Gerontology Research Team for Promoting Independence and Mental Health, Itabashi-ku, Tokyo, Japan.
Int J Geriatr Psychiatry. 2022 Jan;37(1). doi: 10.1002/gps.5635. Epub 2021 Oct 9.
Supporting people suffering from Diogenes Syndrome (DS) is a challenge for geriatric psychiatry. However, there is a lack of knowledge about DS in Japan. Therefore, a systematic longitudinal study to clarify the factors associated with DS and its prognosis was conducted.
METHODS/DESIGN: A retrospective study using data from case records of a municipal psychogeriatric service was conducted. The study population was socially isolated older adults with complex mental health and social care needs who had been referred to the service over 10 years. The participants were stratified into DS and non-DS groups, multivariate analysis was performed to identify factors associated with DS, and survival analysis was performed.
Of the 270 participants, 61 with Environmental Cleanliness and Clutter Scale (ECCS) scores >12 were assigned to the DS group, and 209 with ECCS scores ≤12 were assigned to the non-DS group. On multiple logistic regression analysis, significantly more people in the DS group were living alone, had advanced dementia, and had reduced basic activities of daily living (BADL) compared to the non-DS group. Furthermore, survival analysis showed that the DS group had a higher risk of early death than the non-DS group.
In the present study, social isolation, living alone, advanced dementia, and reduced BADL were found to be associated with DS. In addition, DS had a high risk of early death. Support for DS must take into account not only mental and social health, but also physical health from an early stage.
支持患有“污秽囤积症候群”（DS）的患者是老年精神病学面临的一个挑战。然而，日本对 DS 的了解有限。因此，进行了一项系统的纵向研究，以明确与 DS 相关的因素及其预后。
方法/设计：使用来自市立精神科老年人服务病例记录的回顾性研究。研究人群为具有复杂精神健康和社会护理需求的社会隔离的老年人，他们在 10 多年内向该服务机构提出申请。将参与者分为 DS 和非 DS 组，进行多变量分析以确定与 DS 相关的因素，并进行生存分析。
在 270 名参与者中，有 61 名环境清洁和杂物量表（ECCS）评分>12 分的人被归入 DS 组，209 名 ECCS 评分≤12 分的人被归入非 DS 组。在多变量逻辑回归分析中，与非 DS 组相比，DS 组独居、痴呆程度较重且基本日常生活活动（BADL）能力较差的人明显更多。此外，生存分析表明，DS 组的早期死亡风险高于非 DS 组。
在本研究中，发现社会隔离、独居、痴呆程度较重和 BADL 能力下降与 DS 有关。此外，DS 有较高的早期死亡风险。支持 DS 必须考虑到心理健康和社会健康，还必须从早期开始考虑身体健康。
