Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Department of Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
J Alzheimers Dis. 2022;87(3):1307-1318. doi: 10.3233/JAD-215198.
The majority of individuals with dementia will suffer from behavioral and psychological symptoms of dementia (BPSD). These symptoms contribute to functional impairment and caregiver burden.
To characterize BPSD in Alzheimer's disease (AD), vascular dementia (VaD), mixed (Mixed) dementia, Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and unspecified dementia in individuals residing in long-term care facilities.
We included 10,405 individuals with dementia living in long-term care facilities from the Swedish registry for cognitive/dementia disorders (SveDem) and the Swedish BPSD registry. BPSD was assessed with the Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). Multivariate logistic regression models were used to evaluate the associations between dementia diagnoses and different BPSDs.
The most common symptoms were aberrant motor behavior, agitation, and irritability. Compared to AD, we found a lower risk of delusions (in FTD, unspecified dementia), hallucinations (FTD), agitation (VaD, PDD, unspecified dementia), elation/euphoria (DLB), anxiety (Mixed, VaD, unspecified dementia), disinhibition (in PDD), irritability (in DLB, FTD, unspecified dementia), aberrant motor behavior (Mixed, VaD, unspecified dementia), and sleep and night-time behavior changes (unspecified dementia). Higher risk of delusions (DLB), hallucinations (DLB, PDD), apathy (VaD, FTD), disinhibition (FTD), and appetite and eating abnormalities (FTD) were also found in comparison to AD.
Although individuals in our sample were diagnosed with different dementia disorders, they all exhibited aberrant motor behavior, agitation, and irritability. This suggests common underlying psychosocial or biological mechanisms. We recommend prioritizing these symptoms while planning interventions in long-term care facilities.
大多数痴呆患者会出现行为和心理症状的痴呆（BPSD）。这些症状导致功能障碍和照顾者负担。
描述居住在长期护理机构中的阿尔茨海默病（AD）、血管性痴呆（VaD）、混合性痴呆（Mixed）、帕金森病痴呆（PDD）、路易体痴呆（DLB）、额颞叶痴呆（FTD）和未明确痴呆患者的 BPSD 特征。
我们纳入了来自瑞典认知/痴呆障碍登记处（SveDem）和瑞典 BPSD 登记处的 10405 名居住在长期护理机构的痴呆患者。使用神经精神问卷-护理院版（NPI-NH）评估 BPSD。采用多变量逻辑回归模型评估不同痴呆诊断与不同 BPSD 之间的关联。
最常见的症状是异常运动行为、激越和烦躁不安。与 AD 相比，我们发现妄想（FTD、未明确痴呆）、幻觉（FTD）、激越（VaD、PDD、未明确痴呆）、欣快/兴奋（DLB）、焦虑（混合、VaD、未明确痴呆）、冲动控制障碍（Mixed、VaD、未明确痴呆）、烦躁不安（DLB、FTD、未明确痴呆）、异常运动行为（Mixed、VaD、未明确痴呆）和睡眠及夜间行为改变（未明确痴呆）的风险较低。与 AD 相比，还发现妄想（DLB）、幻觉（DLB、PDD）、淡漠（VaD、FTD）、冲动控制障碍（FTD）和食欲和饮食异常（FTD）的风险更高。
尽管我们样本中的患者被诊断为不同的痴呆症，但他们都表现出异常运动行为、激越和烦躁不安。这表明存在共同的潜在心理社会或生物学机制。我们建议在长期护理机构中规划干预措施时，优先考虑这些症状。
