Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA.
Lundbeck, LLC. Deerfield, IL, USA.
J Alzheimers Dis. 2022;88(2):663-677. doi: 10.3233/JAD-215670.
Dementia patients frequently depend on caregivers. Agitation is a common behavioral dementia symptom particularly burdensome to patients and caregivers.
To assess the association of agitation severity with non-professional caregiver hours, burden, health status, and productivity. Secondarily, to assess the association of agitation severity with these outcomes for patients receiving remote (not living with the patient) and proximate (living with the patient) caregiving.
A retrospective analysis of physician and non-professional caregiver-reported data from a US point-in-time survey. Patients were aged ≥50 years, with early cognitive impairment or dementia. Regression analyses compared outcomes by agitation severity; covariates included age, sex, and clinical characteristics.
Data were included for 1,349 patients (non-agitated n = 656, agitated n = 693; no care n = 305, remote care n = 248, proximate care n = 691; unknown care n = 105). Greater agitation was significantly associated (p < 0.05) in all caregivers with increasing: Zarit Burden Interview (ZBI) Total Caregiver Burden, Personal Strain, Role Strain, and Guilt; Work Productivity and Activity Index (WPAI) presenteeism, overall work impairment, and total activity impairment. Higher ZBI Total Caregiver Burden, Personal Strain, and Role Strain were associated with greater agitation in proximate caregivers and higher ZBI Guilt associated with greater agitation in remote caregivers (p < 0.05). Higher WPAI presenteeism and total activity impairment were associated (p < 0.05) with greater agitation in proximate caregivers. Caregiving hours increased with increasing agitation for proximate caregiving (p = 0.001).
Greater agitation severity was associated with higher caregiver burden and lower productivity, with higher indirect costs a likely outcome of agitation.
痴呆症患者经常依赖护理人员。激越行为是一种常见的行为性痴呆症症状，对患者和护理人员来说尤其负担沉重。
评估激越严重程度与非专业护理人员时间、负担、健康状况和生产力之间的关联。其次，评估激越严重程度与接受远程（不与患者同住）和近端（与患者同住）护理的患者这些结果之间的关联。
对美国即时调查中医生和非专业护理人员报告数据的回顾性分析。患者年龄≥50 岁，有早期认知障碍或痴呆症。回归分析比较了不同激越严重程度的结果；协变量包括年龄、性别和临床特征。
纳入了 1349 名患者（无激越患者 656 名，激越患者 693 名；无护理人员 305 名，远程护理人员 248 名，近端护理人员 691 名；未知护理人员 105 名）的数据。在所有护理人员中，激越程度越高，Zarit 负担访谈（ZBI）总护理负担、个人压力、角色压力和内疚感，工作生产力和活动指数（WPAI）的出勤、总体工作障碍和总活动障碍也越严重（p＜0.05）。在近端护理人员中，ZBI 总护理负担、个人压力和角色压力越高，与激越程度的相关性越强，而在远程护理人员中，ZBI 内疚感与激越程度的相关性越强（p＜0.05）。WPAI 的出勤和总活动障碍与近端护理人员的激越程度呈正相关（p＜0.05）。近端护理时间随着激越程度的增加而增加（p=0.001）。
激越严重程度与护理人员负担增加和生产力降低有关，激越可能导致间接成本增加。
