Teri L
Department of Psychiatry and Behavioral Science, University of Washington, Seattle 98195, USA.
Alzheimer Dis Assoc Disord. 1997;11 Suppl 4:S35-8.
Behavioral dysfunction in Alzheimer disease (AD) is a major influence on the morbidity and disability of patients and is central to decisions on patient institutionalization. Behavioral dysfunction ranges from withdrawal, apathy, and depression to hostility, anger, and aggression, with most patients exhibiting some symptoms during the course of the disease. Symptoms of depression are common in AD patients (17-30%) and are associated with broad behavioral dysfunction and increased functional disability. Furthermore, the occurrence of depression in patients correlates strongly with caregiver burden and depression. This report summarizes the relationship between caregiver distress and patient behavioral problems. Administration of the Revised Memory and Behavior Problem Checklist provided information on the frequency of behavioral problems and their association with caregiver distress. In one study of 201 patient-caregiver dyads, depression-related behaviors were confirmed as the most distressing to caregivers. In another, the rates of caregiver depression were high (75%) among those caring for clinically depressed AD patients. Indeed, in a third study, 100% of patients with depression had depressed caregivers. The vulnerability of caregivers to depression is linked to their own age, gender, physical ability, personality, and available social supports. Alleviation of caregiver distress, burden, and depression will be of great value in the improvement of AD patient care.
阿尔茨海默病（AD）中的行为功能障碍对患者的发病率和残疾情况有重大影响，并且是决定患者是否需要住院治疗的关键因素。行为功能障碍的范围很广，从退缩、冷漠和抑郁到敌意、愤怒和攻击行为，大多数患者在疾病过程中都会表现出一些症状。抑郁症状在AD患者中很常见（17%-30%），并且与广泛的行为功能障碍和功能残疾增加有关。此外，患者出现抑郁与照料者负担及抑郁密切相关。本报告总结了照料者困扰与患者行为问题之间的关系。使用修订后的记忆与行为问题清单提供了关于行为问题发生频率及其与照料者困扰之间关联的信息。在一项针对201对患者-照料者二元组的研究中，与抑郁相关的行为被证实是照料者最苦恼的问题。在另一项研究中，照料临床上患有抑郁症的AD患者的人群中，照料者抑郁的发生率很高（75%）。实际上，在第三项研究中，患有抑郁症的患者中有100%的照料者也患有抑郁症。照料者易患抑郁症与他们自身的年龄、性别、身体能力、性格以及可获得的社会支持有关。减轻照料者的困扰、负担和抑郁对于改善AD患者的护理将具有重要价值。
