北京部分城乡社区老年人和痴呆患者神经精神症状的调查

Neuropsychiatric symptoms in dementia and elderly people in the community:results from the Beijing Dementia Cooperative Study

目的 研究社区老年人和轻中度痴呆患者神经精神症状的表现及其患病率。方法 采用国际通用的神经精神科问卷(NPI)对北京市城乡1540名认知功能正常的65岁及其以上老年人和373名痴呆患者的神经精神症状进行了调查。结果 痴呆患者中49.33％在近一个月内出现过至少一种神经精神症状(35.66％为临床显著性症状),其中80.4％出现2种以上的神经精神症状。痴呆患者最常见的症状包括抑郁/心境恶劣(23.86％),情感淡漠/漠不关心(21.72％),焦虑(20.38％)。正常老年人中有18.25％在近一个月内出现过至少一种神经精神症状(6.49％为临床显著性症状),其中53％出现2种以上的神经精神症状。老年人中最常见的症状有睡眠障碍(10％),抑郁/心境恶劣(8.9％),焦虑(6.97％)。结论 研究结果显示,痴呆患者神经精神症状患病率较高,程度上也更为严重,更具临床意义,认知功能正常的社区老年人神经精神症状也不容忽视,因此在痴呆的临床诊断过程中要特别关注老年人的精神行为异常。

Objective To determine the prevalence of neuropsychiatric symptoms in dementia and normal elderly people living in the Chinese community of Beijing. Methods A cross-sectional study derived from the Beijing Dementia Cooperative Study was carried out a population survey was carried out on a total of 1540 participants aged 65 years and older living in Beijing city and rural areas. All the individuals and 373 demented elderly people completed a series of neuropsychological examination and the Neuropsychiatric Inventory (NPI). Results Among the dementia participants, 49.33 % had exhibited neuropsychiatric symptoms (35.66 % rated as clinically significant), in which 80.4 % reported 2 or more disturbances, with depression (23.86 % ), apathy (21.72%) and anxiety (20.38 % ) being most common. Of the 1540 normal individuals, 18.25 % of them exhibited neuropsychiatric symptoms (6.49% rated as clinically significant), in which 53 % reported 2 or more disturbances, with sleepless (10 % ), depression (8.9 % ) and anxiety (6.97 % ) being the most common. Conclusion To our knowledge, this was the first multicenter study on neuropsychiatric disturbances in dementia and cognitive normal elderly people. Neuropsychiatric symptoms occured mainly in persons with dementia and of clinical severity. Though the neuropsychiatric disturbances reported in cognitive normal individuals were lower and less serious compared to dementia, they should not be neglected. These finding suggested that a screening programme focusing on identifying these symptoms should be included in the physician's diagnostic tools for dementia.