阿尔茨海默病精神行为症状亚综合征的影响因素分析

Analysis of the influencing factors of the behavioral and psychological symptoms of dementia sub-syndromes in Alzheimer′s disease

目的探讨阿尔茨海默病(AD)精神行为症状(BPSD)亚综合征的主要影响因素。方法采用自制调查问卷、临床痴呆量表、日常生活能力量表、神经精神科问卷和谵妄评定量表对150例AD患者及其主要照护者进行调查。结果AD患者最常见的BPSD亚综合征依次为情感障碍(131例,87.33%)、精神病性症状(114例,76.00%)、高活动性(64例,42.67%)。BPSD亚综合征因子分与患者基本情况、照护者情况、患者状态、病情严重程度等因素之间仅存在轻至中度相关性(|r|=0.167~0.409,P<0.05)。多元回归分析模型拟合效果均欠佳(R_(adj)^(2)<0.200),基本需求、患者性别、照护者兼职/专职对精神病性症状影响较大,并发症能预测饮食睡眠异常和谵妄的因子分。结论处理并发症、满足患者基本需求、专职的照护者有利于改善BPSD。

Objective To investigate the main factors influencing the behavioral and psychological symptoms of dementia(BPSD)sub-syndromes in Alzheimer′s disease(AD).Methods The self-made questionnaire,clinical dementia rating scale(CDR),activity of daily living scale(ADL),neuropsychiatric inventory(NPI),and confusion assessment method(CAM)were used to survey a total of 150 patients with AD and their primary caregivers.Results The most common BPSD sub-syndromes in AD patients were affective disorder(131 patients,87.33%),psychotic symptoms(114 patients,76.00%),and hyperactivity(64 patients,42.67%).There was only a mild to moderate correlation between the factor scores of BPSD sub-syndromes and basic patient condition,caregiver condition,patient status,and severity of illness(|r|=0.167-0.409,P<0.05).The multiple regression analysis models were all poorly fitted(R_(adj)^(2)<0.200).The basic needs,patient gender and caregiver part-time/full-time had a greater effect on psychotic symptoms.The comorbidity could predict the factor scores for eating-sleep abnormalities and delirium.Conclusion Managing comorbidity,meeting patients′basic needs,and the dedicated caregivers are beneficial in improving BPSD.