Clare Linda, Gamble Laura D, Martyr Anthony, Henderson Catherine, Knapp Martin, Matthews Fiona E
University of Exeter Medical School, University of Exeter, (L.C, A.M), Exeter, UK; NIHR Applied Research Collaboration South-West Peninsula, (L.C), Exeter, UK.
Population Health Sciences Institute, Newcastle University, (L.D.G, F.E.M) Newcastle, UK.
Am J Geriatr Psychiatry. 2024 Nov;32(11):1309-1321. doi: 10.1016/j.jagp.2024.05.012. Epub 2024 Jun 6.
To compare the experiences of people with dementia living alone or with others and how these may change over two years.
We analysed longitudinal data from three assessment waves, one year apart, in the British IDEAL cohort.
Participants with mild-to-moderate dementia were recruited through National Health Service providers, where possible with a family caregiver, and interviewed at home.
The current analyses include 281 people with dementia living alone and 1,244 living with others at baseline; follow-up data were available for 200 and 965 respectively at time 2 and 144 and 696 respectively at time 3. For those living alone, 140 nonresident caregivers contributed at baseline, 102 at time 2 and 81 at time 3. For those living with others, 1,127 family caregivers contributed at baseline, 876 at time 2 and 670 at time 3.
Assessments covered: cognitive and functional ability; self-reported perceptions of health, mood, social engagement, quality of life, satisfaction with life and well-being; use of in-home and community care; and transitions into residential care.
People living alone tended to have better cognitive and functional ability and were more frequent users of in-home care. However, they experienced poorer physical, social, and psychological health and reduced quality of life, satisfaction with life, and well-being. These differences persisted over time and rates of transition into residential care were higher.
To facilitate continuing in place for people with dementia living alone, a dual focus on supporting functional ability and add ressing psychosocial needs is essential in the context of an enabling policy framework.
比较独居或与他人同住的痴呆症患者的经历，以及这些经历在两年内可能如何变化。
我们分析了英国IDEAL队列中相隔一年的三次评估波次的纵向数据。
轻度至中度痴呆症患者通过国民保健服务提供者招募，尽可能有家庭照顾者，并在家中接受访谈。
目前的分析包括基线时281名独居的痴呆症患者和1244名与他人同住的患者；随访数据在第2次时分别有200名和965名可用，在第3次时分别有144名和696名可用。对于独居者，140名非居住照顾者在基线时提供帮助，第2次时有102名，第3次时有81名。对于与他人同住者，1127名家庭照顾者在基线时提供帮助，第2次时有876名，第3次时有670名。
评估涵盖：认知和功能能力；自我报告的健康、情绪、社会参与、生活质量、生活满意度和幸福感；家庭和社区护理的使用；以及向寄宿护理的转变。
独居者往往具有更好的认知和功能能力，并且更频繁地使用家庭护理。然而，他们的身体、社会和心理健康状况较差，生活质量、生活满意度和幸福感降低。这些差异随着时间持续存在，并且向寄宿护理的转变率更高。
为了便于独居的痴呆症患者继续居家，在有利的政策框架背景下，双重关注支持功能能力和满足心理社会需求至关重要。
