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路易体痴呆比阿尔茨海默病更常见功能丧失和老年评估参数恶化。

Functional loss and worsening geriatric assessment parameters are more common in dementia with Lewy bodies than Alzheimer's disease.

机构信息

Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkiye.

Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey.

出版信息

Psychogeriatrics. 2023 Jan;23(1):77-85. doi: 10.1111/psyg.12905. Epub 2022 Nov 9.

Abstract

BACKGROUND

The main aim of this study was to compare older patients with Alzheimer's disease (AD) to those with dementia with Lewy bodies (DLB) according to their dependency in daily living activities and comprehensive geriatric assessment parameters.

METHOD

A total of 227 AD and 123 DLB patients underwent a geriatric assessment that included comorbidities, number of drugs used, falls, urinary incontinence, hand grip strength, Mini-Nutritional Assessment (MNA), Tinetti Performance Oriented Mobility Assessment Scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale. Basic and instrumental activities of daily living were assessed by the Barthel Index and the Lawton scale, respectively.

RESULTS

The mean age of the participants was 83.4 years, and 73% were female. There were no statistically significant differences between AD and DLB patients in age, gender, cognitive function, or comorbidities except for coronary artery disease (P < 0.05). The number of falls, drugs used, and ISI and Epworth scores were higher in patients with DLB than patients with AD (P < 0.05). DLB patients had lower MNA, Tinetti scale, and hand grip strength scores than AD patients. The ratio of patients highly dependent in basic daily activities as a whole was significantly greater in DLB than in AD (P < 0.05), but there was no significant difference in the overall levels of dependency in instrumental activities.

CONCLUSION

DLB patients are more dependent on their caregivers than AD patients. Nutritional deterioration, sleep disorders, falls, balance and gait problems, decreased muscle strength, and multiple drug use are more common in those with DLB compared to those with AD. The management of older patients with DLB may be more difficult than older patients with AD.

摘要

背景

本研究的主要目的是根据日常生活活动依赖和综合老年评估参数,比较阿尔茨海默病(AD)老年患者与路易体痴呆(DLB)老年患者。

方法

共纳入 227 例 AD 患者和 123 例 DLB 患者进行老年评估,包括合并症、使用药物的数量、跌倒、尿失禁、手握力、迷你营养评估(MNA)、Tinetti 表现定向移动评估量表、失眠严重程度指数(ISI)和 Epworth 嗜睡量表。日常生活的基本和工具活动分别由巴氏指数和 Lawton 量表评估。

结果

参与者的平均年龄为 83.4 岁,73%为女性。AD 和 DLB 患者在年龄、性别、认知功能或合并症方面无统计学差异,除了冠心病(P<0.05)。与 AD 患者相比,DLB 患者跌倒、使用药物的数量、ISI 和 Epworth 评分更高(P<0.05)。DLB 患者的 MNA、Tinetti 量表和手握力评分低于 AD 患者。整体基本日常生活活动高度依赖的患者比例 DLB 显著高于 AD(P<0.05),但工具性日常生活活动的整体依赖程度无显著差异。

结论

DLB 患者比 AD 患者更依赖护理人员。与 AD 患者相比,DLB 患者更容易出现营养不良、睡眠障碍、跌倒、平衡和步态问题、肌肉力量下降和多种药物使用。DLB 老年患者的管理可能比 AD 老年患者更困难。

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