Neuropsychiatric symptoms and the risk of institutionalization and death: the aging, demographics, and memory study.
Neuropsychiatric symptoms and the risk of institutionalization and death: the aging, demographics, and memory study.
复制标题
DOI：
10.1111/j.1532-5415.2011.03314.x
复制
发表时间：
2011-03
影响因子：
6.3
通讯作者：
Langa KM
中科院分区：
文献类型：
--
作者：
Okura T;Plassman BL;Steffens DC;Llewellyn DJ;Potter GG;Langa KM
To examine the association of neuropsychiatric symptoms with risk of institutionalization and death. Analysis of longitudinal data The Aging, Demographics, and Memory Study (ADAMS) A sample (n=537) of adults aged 71 or older with cognitive impairment drawn from the Health and Retirement Study (HRS) The presence of neuropsychiatric symptoms (delusions, hallucinations, agitation, depression, apathy, elation, anxiety, disinhibition, irritation, and aberrant motor behaviors) and caregiver distress were identified using the Neuropsychiatric Inventory. Cognitive category was assigned in the ADAMS by a consensus panel. Date of nursing home placement and death, functional limitations, medical comorbidity, and sociodemographics were obtained from the HRS and ADAMS. Overall, the presence of 1 or more neuropsychiatric symptoms was not associated with a significantly higher risk for either institutionalization or death during the 5-year study period. However, when assessing each symptom individually, the presence of depression, delusions, and agitation were each associated with a significantly higher risk of institutionalization (HR, 3.06; 95% CI, 1.09-8.59 for depression; HR, 5.74; 95% CI, 1.94-16.96 for clinically significant delusions; HR, 4.70; 95% CI, 1.07-20.70 for clinically significant agitation). The association of delusions and agitation with institutionalization was mediated by caregiver distress. The presence of depression and hallucinations were each associated with a significantly higher mortality (HR, 1.56; 95% CI, 1.08-2.26 for depression; HR, 2.59; 95% CI, 1.09-6.16 for clinically significant hallucinations). Some, but not all, neuropsychiatric symptoms are associated with a higher risk of institutionalization and death among those with cognitive impairment, and some are additionally influenced by caregiver distress. Interventions that better target and treat the neuropsychiatric symptoms of depression, delusions, agitation, and hallucinations, as well as caregiver distress, may help delay or prevent these negative clinical outcomes.
登录
查看更多内容
影响因子：
5.7
作者：
Langa, KM;Plassman, BL;Willis, RJ
通讯作者：
Willis, RJ
影响因子：
6.9
作者：
FORSTL, H;BURNS, A;LEVY, R
通讯作者：
LEVY, R
DOI：
10.1093/geronb/53b.5.p294
发表时间：
1998-09-01
影响因子：
6.2
作者：
Logsdon, RG;Teri, L;Larson, EB
通讯作者：
Larson, EB
影响因子：
4
作者：
Herrmann, Nathan;Lanctot, Krista L.;Nguyen, Elizabeth
通讯作者：
Nguyen, Elizabeth
影响因子：
120.7
作者：
Lyketsos, CG;Lopez, O;DeKosky, S
通讯作者：
DeKosky, S