记忆门诊阿尔茨海默病患者的精神行为症状分析

目的 研究记忆门诊不同阶段阿尔茨海默病(AD)患者的精神行为症状的特点,了解不同阶段AD患者的精神行为症状的差异及影响因素.方法 纳入AD患者143例,轻度、中度、重度AD分别为64、56、23例,采用MMSE、ADL、NPI评估AD患者的认知功能,日常生活能力、精神行为症状.依据MMSE评分将被试者分为轻度(MMSE≥20,65例)、中度(MMSE=11~19,56例)和重度(MMSE≤10, 23例)三组,比较不同阶段AD患者精神行为症状的特征,并研究精神行为症状的潜在相关因素.结果 AD患者出现至少一个精神行为症状的发生率为83.2%,轻度AD出现至少一个精神行为症状的发生率为76.6%,中度AD为83.9%,而重度AD为100%.轻度AD中最常见的三种症状为抑郁、易激惹、焦虑;中度AD最常见的三种症状为淡漠、抑郁、焦虑.重度AD最常见的三种症状为妄想、抑郁、易激惹和异常举动.中度AD淡漠的发生率高于轻度和重度.轻度 AD的激越程度高于中度AD.NPI总分随着MMSE下降及 ADL分值的增加而增加.幻觉、妄想、淡漠、异常举动、夜间行为与MMSE存在不同程度负相关;妄想、淡漠、异常举动与ADL存在不同程度正相关.结论 记忆门诊AD患者精神行为症状发生率高,不同阶段AD精神行为症状特点有差异.

Objective To study the characteristics of behavioral and psychological symptoms of dementia(BPSD)and understand the differences and its influencing factors in patients with AD at different stages in memory clinic.Methods 143 patients with AD were enrolled in this study.The cognitive function,daily living ability,and Behavioral and psychological symptoms of dementia of patients were investigated by scales of MMSE,ADL,and NPI.The subjects were divided into three groups:mild(MMSE≥20,65 cases),moderate(MMSE=11~19,56 cases)and severe(MMSE≤10,23 cases).The characteristics of BPSD among the three groups were compared and the potential related factors of BPSD were study.Results The incidence of at least one BPSD in AD patients was 83.2%,mild AD was 76.6%,moderate AD was 83.9%,and severe AD was 100%.The most common three symptoms in mild AD were depression,irritability,and anxiety;moderate AD were apathy,depression,and anxiety.Severe AD were delusions,depression,irritability,and abnormal behavior.The incidence of apathy in moderate AD was higher than mild and severe.Agitation in mild AD was more severe than moderate AD.The total NPI score increased with the decrease of MMSE and the increase of ADL score.Conclusions The incidence of behavioral and psychological symptoms of dementia in patients with AD is high,and there are differences in the characteristics of behavioral and psychological symptoms of dementia at different stages.