Predictors of neuropsychiatric symptoms in nursing home patients: influence of gender and dementia severity

被引:74
|
作者
Zuidema, Sytse U. [1 ]
de Jonghe, Jos F. M. [2 ,3 ]
Verhey, Frans R. J. [4 ]
Koopmans, Raymond T. C. M. [1 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Primary & Community Care, Ctr Family Med Geriatr Care & Publ Hlth, NL-6500 HB Nijmegen, Netherlands
[2] Med Ctr Alkmaar, Dept Clin Psychol, Alkmaar, Netherlands
[3] Med Ctr Alkmaar, Dept Geriatr Med, Alkmaar, Netherlands
[4] Univ Hosp Maastricht, Dept Psychiat & Neuropsychol, Maastricht, Netherlands
关键词
dementia; neuropsychiatric symptoms; nursing home; MANSFIELD AGITATION INVENTORY; PSYCHIATRIC-SYMPTOMS; BEHAVIORAL DISTURBANCES; PSYCHOLOGICAL SYMPTOMS; AGGRESSIVE BEHAVIORS; DUTCH VERSION; RESIDENTS; PREVALENCE; APATHY; DEPRESSION;
D O I
10.1002/gps.2225
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Introduction The aim of the study was to assess the influence of dementia severity and gender on neuropsychiatric symptoms in demented nursing home patients. Methods Neuropsychiatric symptoms were assessed in a large sample of 1319 Dutch nursing home patients using the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). The influence of gender and severity of cognitive decline, assessed with the Global Deterioration Scale (GDS), was investigated using logistic regression analysis and Subsequently corrected for possible confounders, such as age, duration of institutionalization and psychoactive medication use. Results While physically aggressive behaviour was more common in patients with very severe cognitive deterioration (GDS stage 7), disinhibition, irritability, physically non-aggressive and verbally agitated behaviour were more common in patients in GDS stage 5 or 6. Physically aggressive behaviour was more common in men, whereas female patients demonstrated more verbally agitated behaviour. With respect to other neuropsychiatric symptoms, delusions and depression were also more common in patients in GDS stage 5 and 6, while prevalences of anxiety and apathy further increased in severely demented patients (GDS stage 7). Apathy was more prevalent in mate patients, while depression and anxiety were more common in females. Conclusion In nursing home patients, neuropsychiatric symptoms were associated with the severity of dementia, with most symptoms occurring in patients showing (moderately) severe cognitive decline. Only physical aggression, anxiety and apathy were more common in patients with very severe cognitive decline. Dementia severity and gender were important predictors of neuropsychiatric symptoms in this patient cohort. Copyright (C) 2009 John Wiley & Sons, Ltd.
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收藏
页码:1079 / 1086
页数:8
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