Department of Psychiatry, 36596Changhua Christian Hospital, Changhua, Taiwan.
Department of Psychiatry, Yuanlin Christian Hospital, Changhua, Taiwan.
J Appl Gerontol. 2022 May;41(5):1357-1364. doi: 10.1177/07334648211073129. Epub 2022 Feb 27.
This study aimed to examine the institutionalization rate in patients with dementia in Taiwan, identify the predictors of institutionalization, and conduct a mediation analysis of caregiver burden between neuropsychiatric symptoms and institutionalization. We analyzed data from a retrospective cohort registered in dementia collaborative care ( = 518). The analyses applied univariate and multivariate Cox proportional hazard regression with Firth's penalized likelihood to assess the relationship between each predictor at entry and institutionalization for survival analysis. Thirty (5.8%) patients were censored due to institutionalization after a median follow-up of one-and-a-half years. Neuropsychiatric symptoms, loss of walking ability, and living alone predicted institutionalization. Caregiver burden may partially mediate the effects of neuropsychiatric symptoms and institutionalization. High caregiver burden due to presence of neuropsychiatric symptoms may partially contribute to institutionalization among people living with dementia in Taiwan. However, proper management of neuropsychiatric symptoms and caregiver empowerment may ameliorate institutionalization risk.
本研究旨在探讨台湾地区痴呆患者的机构化率，确定其机构化的预测因素，并对 caregiver 负担在神经精神症状与机构化之间的中介作用进行分析。我们分析了在痴呆协作护理中注册的回顾性队列的数据（n=518）。采用单变量和多变量 Cox 比例风险回归与 Firth 的惩罚似然法，对进入研究时每个预测因素与生存分析中机构化之间的关系进行评估。由于中位数为 1.5 年的随访后发生机构化，有 30 名（5.8%）患者被删失。神经精神症状、丧失行走能力和独居预测机构化。 caregiver 负担可能部分中介了神经精神症状和机构化的影响。由于存在神经精神症状导致 caregiver 负担高，可能部分导致台湾地区痴呆患者的机构化。然而，适当管理神经精神症状和 caregiver 赋权可能会降低机构化风险。
