中晚期阿尔茨海默病与血管性痴呆的神经精神症状及照护者负担比较

Neuropsychiatric symptoms and caregiver burden on patients with moderate and severe Alzheimer's disease or vascular dementia

目的:比较中晚期阿尔茨海默病(Alzheimer’Sdisease,AD)与血管性痴呆(vascular dementia,VD)患者神经精神症状的发病率,严重程度与照顾者负担的差异。方法:招募住院中晚期阿尔茨海默病与血管性痴呆患者共77例,对其照顾者采用国际通用的神经精神科问卷(NPI)进行评估。结果:两组中晚期痴呆患者的神经精神症状总发生率为94.8%,发生率最高的依次为淡漠(53.2%),异常运动(41.6%),夜间行为障碍(36.4%)和激越/攻击(35.1%)。中晚期AD患者激越,脱抑制,易激惹等活动过度综合征行为的发生率明显高于中晚期VD患者,而抑郁等情绪/淡漠综合征低于中晚期VD患者。然而,各症状的NPI评分和照顾者负担评分在两组痴呆人群的照护者中无差异。结论:中晚期痴呆患者的神经精神症状发生率较高,AD患者激越,脱抑制,易激惹等活动过度综合征行为的发生率更高,而VD患者抑郁等情绪/淡漠综合征发生率更高。两组中晚期痴呆患者照护者负担无差异。

Objective To investigate the difference of neuropsychiatric symptoms and caregiver burden on patients with moderate and severe Alzheimer’s disease or vascular dementia.Methods A total of 77 admitted patients with moderate and severe Alzheimer’s disease or vascular dementia and their caregivers were recruited and evaluated by Neuropsychiatric Inventory(NPI).Results The prevalence of neuropsychiatric symptoms is 94.8 among all patients with moderate and severe dementia,and apathy(53.2%),aberrant motor behaviour(41.6%),night-time behaviour(36.4%),and agitation(35.1%)are the most common symptoms.The rate of agitation,disinhibition,irritability in AD group were more common than in VD group;while the rate of depression were more common in VD group than AD group.However,the scores of both NPI and burden of caregivers show no significant difference.Conclusions It is high prevalence of neuropsychiatric symptoms in patients with moderate and severe dementia.Agitation,disinhibition,irritability were the most common in AD group,and depression was the most common in VD group.There was not different between AD and VD group in caregiver burden.