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早期阿尔茨海默病患者的医疗求助意向。

Medical help-seeking intentions among patients with early Alzheimer's disease.

作者信息

Villarejo-Galende Alberto, García-Arcelay Elena, Piñol-Ripoll Gerard, Del Olmo-Rodríguez Antonio, Viñuela Félix, Boada Mercè, Franco-Macías Emilio, Ibañez de la Peña Almudena, Riverol Mario, Puig-Pijoan Albert, Abizanda-Soler Pedro, Arroyo Rafael, Baquero-Toledo Miquel, Feria-Vilar Inmaculada, Balasa Mircea, Berbel Ángel, Rodríguez-Rodríguez Eloy, Vieira-Campos Alba, Garcia-Ribas Guillermo, Rodrigo-Herrero Silvia, Lleó Alberto, Maurino Jorge

机构信息

Department of Neurology, Hospital Universitario 12 de Octubre, Instituto de Investigación Imas12, Universidad Complutense de Madrid, Madrid, Spain.

Medical Department, Roche Farma, Madrid, Spain.

出版信息

Front Psychiatry. 2023 Dec 19;14:1290002. doi: 10.3389/fpsyt.2023.1290002. eCollection 2023.

Abstract

BACKGROUND

Limited information is available on the active process of seeking medical help in patients with Alzheimer's disease (AD) at early stages. The aim of this study was to assess the phenomenon of medical help-seeking in early AD and to identify associated factors.

METHODS

A multicenter, non-interventional study was conducted including patients of 50-90 years of age with prodromal or mild AD (National Institute on Aging/Alzheimer's Association criteria), a Mini-Mental State Examination (MMSE) score ≥ 22, and a Clinical Dementia Rating-Global score (CDR-GS) of 0.5-1.0. A multivariate logistic regression analysis was conducted.

RESULTS

A total of 149 patients were included. Mean age (SD) was 72.3 (7.0) years, 50.3% were female, and 87.2% had a CDR-GS score of 0.5. Mean disease duration was 1.4 (1.8) years. Ninety-four (63.1%) patients sought medical help, mostly from neurologists. Patients with help-seeking intentions were mostly female (60.6%) with a CDR-GS score of 0.5 (91.5%) and had a greater awareness of diagnosis, poorer quality of life, more depressive symptoms, and a more severe perception of their condition than their counterparts. Lack of help-seeking intentions was associated with male sex ( = 0.003), fewer years of education ( = 0.005), a low awareness of diagnosis ( = 0.005), and a low emotional consequence of the condition ( = 0.016).

CONCLUSION

Understanding the phenomenon of active medical help-seeking may facilitate the design of specific strategies to improve the detection of cognitive impairment, especially in patients with a lower level of educational attainment and poor awareness of their condition.

摘要

背景

关于早期阿尔茨海默病(AD)患者主动寻求医疗帮助的实际过程,现有信息有限。本研究旨在评估早期AD患者寻求医疗帮助的现象,并确定相关因素。

方法

开展了一项多中心、非干预性研究,纳入年龄在50 - 90岁之间、患有前驱期或轻度AD(根据美国国立衰老研究所/阿尔茨海默病协会标准)、简易精神状态检查表(MMSE)评分≥22且临床痴呆评定量表总体评分(CDR - GS)为0.5 - 1.0的患者。进行了多因素逻辑回归分析。

结果

共纳入149例患者。平均年龄(标准差)为72.3(7.0)岁,50.3%为女性,87.2%的CDR - GS评分为0.5。平均病程为1.4(1.8)年。94例(63.1%)患者寻求了医疗帮助,大多是向神经科医生求助。有寻求帮助意向的患者大多为女性(60.6%),CDR - GS评分为0.5(91.5%),与未寻求帮助的患者相比,她们对诊断的认知度更高、生活质量更差、抑郁症状更多,且对自身病情的感知更严重。未寻求帮助意向与男性(P = 0.003)、受教育年限较少(P = 0.005)、对诊断的认知度较低(P = 0.005)以及病情的情感影响较小(P = 0.016)相关。

结论

了解主动寻求医疗帮助的现象可能有助于设计特定策略,以改善认知障碍的检测,尤其是在受教育程度较低且对自身病情认知不足的患者中。

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