Vicente-Alba Javier, Gutiérrez-Botella Jesús, García-Mahía Carmen, Mateos Raimundo
Psychiatry Service, Vigo's Health Area, Vigo, Pontevedra, Spain.
Psychiatry Department, University of Santiago de Compostela (USC), Santiago de Compostela, A Coruña, Spain.
Front Psychiatry. 2024 Dec 17;15:1481898. doi: 10.3389/fpsyt.2024.1481898. eCollection 2024.
Cognitive impairment and dementia are part of a continuum that progressively leads to functional impairment and dependency. Dementia is a paradigmatic example of chronic and complex psychogeriatric diseases, requiring a comprehensive assessment. The authors underline the importance of implementing a formal assessment of needs (whether met or unmet) as an essential element of comprehensive assessment. The aim of this paper is to empirically validate this model of approach towards dementia, the needs assessment, demonstrating the relationship between needs and functionality/dependency in people with cognitive impairment/dementia in the community.
Community-based, cross-sectional, descriptive epidemiological study based on the reanalysis of data from a two-phase community epidemiological study conducted in Santiago de Compostela, Spain, of 800 people over 65 years of age. The present study reanalyzes a subsample of 368 people, including those with dementia/cognitive impairment. The comprehensive assessment of the sample included sociodemographic variables, the presence of chronic diseases, health self-perception, assessment of affective, cognitive and functional state, as well as the needs assessment. The main instruments used were the MMSE, the Geriatric Depression Scale (GDS), the Barthel and Katz Indices, the Lawton Scale, and, for the needs assessment, the Camberwell Assessment of Need for the Elderly (CANE). For the clinical diagnosis of dementia, the ICD-10 criteria were followed. Statistical analysis: A study of the association between variables was carried out through hypothesis testing and a multivariate study was performed using regression models to analyze the relationship between the different variables defining disability/dependency, other health conditions and sociodemographic variables and the MMSE score as an expression of the cognitive impairment/dementia continuum.
People with cognitive impairment/dementia had a higher number of needs compared to the healthy population. The severity of cognitive impairment is a significant predictor of dependency in Basic Activities of Daily Living (BADL) and is also a predictor of a greater number of needs (both met and unmet).
The present study provides empirical evidence of the importance of implementing scales to assess the needs of people with cognitive impairment, as part of the process of comprehensive biopsychosocial assessment and person-centered care for dementia.
认知障碍和痴呆是一个连续体的一部分，会逐渐导致功能障碍和依赖。痴呆是慢性和复杂的老年精神疾病的典型例子，需要进行全面评估。作者强调实施正式的需求评估（无论需求是否得到满足）作为全面评估的一个基本要素的重要性。本文的目的是通过实证验证这种针对痴呆的方法模型，即需求评估，证明社区中认知障碍/痴呆患者的需求与功能/依赖之间的关系。
基于对西班牙圣地亚哥德孔波斯特拉进行的一项两阶段社区流行病学研究的数据进行重新分析的社区横断面描述性流行病学研究，该研究涉及800名65岁以上的人群。本研究重新分析了368人的子样本，包括患有痴呆/认知障碍的人。对样本的全面评估包括社会人口统计学变量、慢性病的存在情况、健康自我认知、情感、认知和功能状态评估，以及需求评估。使用的主要工具包括简易精神状态检查表（MMSE）、老年抑郁量表（GDS）、巴氏指数和卡茨指数、劳顿量表，以及用于需求评估的坎伯韦尔老年需求评估量表（CANE）。对于痴呆的临床诊断，遵循国际疾病分类第十版（ICD - 10）标准。统计分析：通过假设检验对变量之间的关联进行研究，并使用回归模型进行多变量研究，以分析定义残疾/依赖的不同变量、其他健康状况和社会人口统计学变量与作为认知障碍/痴呆连续体表达的MMSE评分之间的关系。
与健康人群相比，认知障碍/痴呆患者的需求数量更多。认知障碍的严重程度是日常生活基本活动（BADL）中依赖的重要预测因素，也是更多需求（包括已满足和未满足的需求）的预测因素。
本研究提供了实证证据，证明在对痴呆进行全面的生物心理社会评估和以患者为中心的护理过程中，实施量表来评估认知障碍患者的需求具有重要意义。
