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中国广州精神障碍住院老年患者的身体状况和日常生活活动:一项横断面研究。

Physical condition and activity of daily living among aging inpatients with mental disorders in Guangzhou, China: a cross-sectional study.

机构信息

Department of Geriatric Neuroscience Center, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.

College of Nursing, Guangzhou Medical University, Guangzhou, China.

出版信息

Psychogeriatrics. 2023 Jul;23(4):657-666. doi: 10.1111/psyg.12974. Epub 2023 May 10.

Abstract

BACKGROUND

The number of elderly with mental disorders is increasing, but few studies have been concerned with the physical condition and activities of daily living (ADL) of these patients. This study aims to describe the physical condition and ADL of patients with mental illnesses (PMI) from different age groups, which provides evidence to improve mental health services for PMI.

METHODS

In this prospective cross-sectional study, the samples were divided into three groups of less than 60 years old (group 1), 60-74 years old (group 2), and over 75 years old (group 3) for comparison. Participants' ADL and physical condition were measure by Barthel Index (BI), Functional Activities Questionnaire (FAQ), Standardised swallowing assessment (SSA) and Short Form of Mini Nutrition Assessment (MNA-SF). The Brief Psychiatric Rating Scale (BPRS) and the Mini-Mental State Examination (MMSE) were used to measure psychological condition.

RESULTS

Totally, 392 participants had been recruited, meanwhile 86% of them were diagnosed with at least one physical disease. There were statistically significant differences in the three groups of participants in BI (F = 50.603, P < 0.001), FAQ (F = 40.332, P < 0.001), SSA (F = 28.574, P < 0.001), and MNA-SF (F = 18.366, P < 0.001). Group 2 and group 3 had significantly lower scores in BI and FAQ than group 1, and the SSA scores were significantly higher than the participants in group 1. In the negative symptoms subscale of BPRS, the mean score of group 3 was significantly higher than groups 1 and 2. Negative symptom subscale has different degrees of correlation with BI (r = -0.537), FAQ (r = 0.643), SSA (r = 0.480), MNA (r = -0.325) and MMSE (r = 0.607). In addition, the participants with comorbidities were related to BI (r = -0.364).

CONCLUSION

Somatic comorbidities play a pivotal role in the clinical characteristics of elderly patients with mental illness, thus greater effort should be paid to elderly patients suffering from mental illness with dysphagia, malnutrition, and cognitive decline. Further, the negative symptoms of elderly patients with mental disorders also deserve attention.

摘要

背景

患有精神障碍的老年人数量不断增加,但很少有研究关注这些患者的身体状况和日常生活活动(ADL)。本研究旨在描述不同年龄组精神疾病患者(PMI)的身体状况和 ADL,为改善 PMI 的心理健康服务提供证据。

方法

在这项前瞻性的横断面研究中,将样本分为三组,年龄小于 60 岁(组 1)、60-74 岁(组 2)和 75 岁以上(组 3)进行比较。采用巴氏指数(BI)、功能活动问卷(FAQ)、标准吞咽评估(SSA)和简化微型营养评估(MNA-SF)量表评估参与者的 ADL 和身体状况。采用简明精神病评定量表(BPRS)和简易精神状态检查(MMSE)评估心理状况。

结果

共招募了 392 名参与者,其中 86%的参与者至少患有一种身体疾病。三组参与者在 BI(F=50.603,P<0.001)、FAQ(F=40.332,P<0.001)、SSA(F=28.574,P<0.001)和 MNA-SF(F=18.366,P<0.001)方面存在统计学差异。组 2 和组 3 的 BI 和 FAQ 评分明显低于组 1,SSA 评分明显高于组 1。在 BPRS 的阴性症状分量表中,组 3 的平均得分明显高于组 1 和组 2。阴性症状分量表与 BI(r=-0.537)、FAQ(r=0.643)、SSA(r=0.480)、MNA(r=-0.325)和 MMSE(r=0.607)呈不同程度的相关性。此外,合并症与 BI(r=-0.364)相关。

结论

躯体合并症在老年精神疾病患者的临床特征中起着关键作用,因此应更加关注患有吞咽困难、营养不良和认知能力下降的老年精神疾病患者。此外,老年精神障碍患者的阴性症状也值得关注。

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