Coyne A C, Reichman W E, Berbig L J
COPSA Institute for Alzheimer's Disease and Related Disorders, UMDNJ-CMHC, Piscataway 08855-1392.
Am J Psychiatry. 1993 Apr;150(4):643-6. doi: 10.1176/ajp.150.4.643.
Alzheimer's disease and other dementias may be associated with greater risk for physical abuse than other illnesses of the elderly. The authors examined the relationship between dementia and abusive behavior in a group of demented patients and their caregivers.
An anonymous questionnaire was distributed to 1,000 caregivers who called a telephone help line specializing in dementia. Demographic characteristics of patients and caregivers were assessed, the occurrence of abuse was examined, and caregivers completed the Zarit Burden Interview and the Zung Self-Rating Depression Scale.
Questionnaires were completed by 342 caregivers. The mean age of caregivers was 56.1 years; 163 (54.5%) were adult children caring for parents, 111 (37.1%) cared for spouses, and 25 (8.4%) cared for other relatives. Thirty-three caregivers (11.9%) reported that they had directed physically abusive behavior (e.g., pinching, shoving, biting, kicking, striking) toward the dementia patient in their care. These caregivers had been providing care for more years, cared for patients functioning at a lower level, displayed higher burden scores, and displayed higher depression scores than caregivers who reported no abuse. In addition, 92 caregivers (33.1%) reported that the patient directed abuse toward them during the course of providing care. Caregivers who had been abused by patients, in comparison to those who had not, were more likely to direct abusive behavior back toward the patient in their care.
These results support the hypothesis that abuse involving cognitively impaired older adults and their caregivers may be associated with the relatively high psychological and physical demands placed on family members who care for relatives with dementia.
与老年人的其他疾病相比，阿尔茨海默病和其他痴呆症可能与身体虐待风险更高有关。作者研究了一组痴呆患者及其照料者中痴呆与虐待行为之间的关系。
向1000名拨打痴呆症专门电话求助热线的照料者发放了一份匿名问卷。评估了患者和照料者的人口统计学特征，检查了虐待行为的发生情况，照料者完成了扎里特负担访谈和zung自评抑郁量表。
342名照料者完成了问卷。照料者的平均年龄为56.1岁；163名（54.5%）是照顾父母的成年子女，111名（37.1%）照顾配偶，25名（8.4%）照顾其他亲属。33名照料者（11.9%）报告称，他们曾对自己照料的痴呆患者实施过身体虐待行为（如掐、推、咬、踢、打）。与未报告虐待行为的照料者相比，这些照料者提供照料的时间更长，照料的患者功能水平更低，负担得分更高，抑郁得分也更高。此外，92名照料者（33.1%）报告称，患者在照料过程中对他们实施了虐待。与未受患者虐待的照料者相比，受患者虐待的照料者更有可能对自己照料的患者回以虐待行为。
这些结果支持了这样一种假设，即涉及认知受损老年人及其照料者的虐待行为可能与照料痴呆亲属的家庭成员所面临的相对较高的心理和身体需求有关。
