阿尔茨海默病、血管性痴呆及其他类型痴呆照顾者负担比较

Comparative analysis of caregiver burden for Alzheimer’s disease,vascular dementia and other types of dementia

目的了解AD、血管性痴呆(VD)及其他类型痴呆(OD)的临床特点,评价不同类型痴呆照顾者负担的差异并分析影响照顾者负担的因素。方法90名老年痴呆病人参加研究小组,采用MMSE、匹兹堡睡眠质量指数(PSQI)、神经精神症状问卷(NPI)、日常生活活动量表(ADL)评估所有病人情况。同时对照顾者一般情况、照顾者负担(CBI)、积极感受和社会支持进行相应的评估。结果VD病人MMSE评分及口服药物种类、执行障碍发生率最高(P<0.05);OD组NPI评分、空间障碍及幻视幻听发生率最高(P<0.05)。3组照顾者性别差异有统计学意义;90%的AD和VD照顾者照顾时间超过1年。AD照顾者所得到的社会支持相对更多(P<0.05),OD照顾者的负担明显高于AD和VD组,且积极感受最低(P<0.05)。多元线性回归分析表明,痴呆类型、护理年限和积极感受是照顾者负担的主要影响因素。结论AD和VD相对其他类型的痴呆照顾者负担较轻,照顾者的负担与照顾者的积极感受、痴呆类型和照顾的年限有关。

Objective To evaluate the symptoms of Alzheimer’s disease(AD),vascular dementia(VaD/VD),and other types of dementia(OD),and to explore the potential influencing factors of caregivers burden.Methods Ninety patients were enrolled in this study.All patients were assessed with the Mini Mental State Examination Scale(MMSE),the Pittsburgh Sleep Quality Index(PSQI),the Neuropsychiatric Symptoms Questionnaire(NPI),and the Activity of Daily Living Scale(ADL).Meanwhile,the caregiver burden(CBI),positive feelings,social support and self-efficacy were evaluated.Results The MMSE score,types of drugs taken,and the incidence rate of executive dysfunction of the VD group were the highest.The NPI scores,and the incidence rate of spatial dysfunction and hallucinations in OD group were the highest.There was a significant difference in sex of caregiver between the three groups.AD and VD patients required longer care time(90%).OD caregivers had the highest burden and lowest positive feelings.AD caregivers had the highest social support.Further analysis showed that dementia type,nursing years and positive feelings were the main influencing factors of caregivers’burden.Conclusions AD and VD caregivers show less burden than other types of dementia caregivers.The burden of care is mainly related to positive feelings of caregivers,type of dementia and the length of care.