住院老年痴呆患者徘徊行为发生情况及危险因素分析

Incidence and risk factors of wander behavior among inpatients with senile dementia

目的 调查住院老年痴呆患者徘徊情况并探讨徘徊的危险因素.方法 选取上海市精神卫生中心老年科住院的84例老年痴呆患者为研究对象,采用Algase徘徊量表（RAWS）、简明智能状态量表（MMSE）及精神神经科问卷（NPI）进行评估,按照徘徊情况分为徘徊组69例和非徘徊组15例,分析徘徊行为相关危险因素.结果 住院老年痴呆徘徊行为的发生率为82.1%,RAWS各因子分中以空间迷失方向感为主要表现形式;徘徊组患者MMSE得分（2.58±5.65）分,低于非徘徊组,NPI总分（17.88±7.93）分,高于非徘徊组,差异均有统计学意义（t值分别为2.89、2.21;P〈0.05）.Logistic逐步多元回归显示,痴呆严重程度、精神行为异常、NPI情感淡漠和徘徊密切相关.结论 徘徊行为在老年痴呆中普遍存在并对照料者形成极大难度,因此对其成因调查对提高老年痴呆患者徘徊行为的医疗、护理及家庭照顾,对防止患者走失、摔倒受伤具有重要现实意义.

Objective To investigate the status quo of wander behavior among inpatients with senile dementia and discuss relevant risk factors.Methods Totally 84 inpatients with senile dementia from the Department of Geriatrics of Shanghai Mental Health Center were selected, evaluated with Revised-Algase Wandering Scale （RAWS）, Mini Mental State Examination （MMSE） and Narcissistic Personality Inventory （NPI）, and divided into a wandering group （69 patients） and a non-wandering group （15 patients）. The risk factors related to wander behavior were analyzed.Results The incidence of wander behavior among the inpatients with senile dementia was 82.1%, with spatial disorientation as the main form in RAWS factor analysis; The MMSE score of the patients in the wandering group was （2.58±5.65）, lower than that of the patients in the non-wandering group, and their NPI score was （17.88±7.93）, higher than that of the patients in the non-wandering group （t=2.89, 2.21;P〈0.05）. According to the Logistic Stepwise Multiple Regression, wander was closely related to severity of dementia, mental and behavior disorder and NPI apatheia.Conclusions Wander behavior is widely found among patients with senile dementia and brings great difficulty to their caregivers. Therefore, studies on their causes play a practical part in improving the treatment, nursing and family care for patients with senile dementia and preventing them from getting lost, felling down and being injured.