Chen I-Wen, Sung Jia-Ying, Wang Wei-Han
Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Int J Geriatr Psychiatry. 2025 Apr;40(4):e70080. doi: 10.1002/gps.70080.
This study examined sleep quality and potential psychological symptoms in primary caregivers of patients with varying dementia severity, considering the presence or absence of significant Behavioral and Psychological Symptoms of Dementia (BPSD).
A total of 280 dementia patients (130 with BPSD, 150 without) and their caregivers were included. Patients with Clinical Dementia Rating scores from 0.5 to 2 were assessed. Caregivers' psychological symptoms, sleep quality, and burden were evaluated using the Symptom Checklist-90-Revised, Pittsburgh Sleep Quality Index, and Caregiver Burden Inventory.
Caregivers of patients with BPSD reported significantly greater psychological distress, burden, and poorer sleep quality than those caring for patients without BPSD. Their distress spanned multiple symptom dimensions, including depression and anxiety. Somatization and phobic anxiety were also more pronounced in caregivers of mild and moderate dementia with BPSD. Among caregivers of patients with BPSD, those of individuals with moderate dementia experienced the highest distress, burden, and poorest sleep quality compared to those with very mild dementia.
BPSD is a major contributor to greater caregiver distress, sleep disturbances, and burden, regardless of dementia severity, or duration alone. These findings highlight the need for targeted interventions to manage BPSD, which may help alleviate caregiver psychological distress and improve sleep quality.
本研究考察了不同痴呆严重程度患者的初级照料者的睡眠质量及潜在心理症状，同时考虑了是否存在明显的痴呆行为和心理症状（BPSD）。
共纳入280名痴呆患者（130名有BPSD，150名无BPSD）及其照料者。对临床痴呆评定量表评分为0.5至2的患者进行评估。使用症状自评量表-90修订版、匹兹堡睡眠质量指数和照料者负担量表评估照料者的心理症状、睡眠质量和负担。
与照料无BPSD患者的照料者相比，有BPSD患者的照料者报告的心理困扰、负担更重，睡眠质量更差。他们的困扰涵盖多个症状维度，包括抑郁和焦虑。在患有BPSD的轻度和中度痴呆患者的照料者中，躯体化和恐惧性焦虑也更为明显。在有BPSD患者的照料者中，与患有极轻度痴呆的患者的照料者相比，患有中度痴呆的患者的照料者所经历的困扰、负担最重，睡眠质量最差。
无论痴呆严重程度或病程长短，BPSD都是导致照料者更大困扰、睡眠障碍和负担的主要因素。这些发现凸显了针对BPSD进行有针对性干预的必要性，这可能有助于减轻照料者的心理困扰并改善睡眠质量。
