The Maryland Assisted Living study: Prevalence, recognition, and treatment of dementia and other psychiatric disorders in the assisted living population of Central Maryland
The Maryland Assisted Living study: Prevalence, recognition, and treatment of dementia and other psychiatric disorders in the assisted living population of Central Maryland
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DOI：
10.1111/j.1532-5415.2004.52452.x
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发表时间：
2004-10-01
影响因子：
6.3
通讯作者：
Lyketsos, CG
中科院分区：
文献类型：
--
作者：
Rosenblatt, A;Samus, QM;Lyketsos, CG
目的：获得马里兰州中部辅助生活（AL）居民中痴呆和其他精神疾病患病率的直接估计，以及他们的认知率和治疗率。设计：使用广泛接受的工具对随机队列AL居民的病史、认知和神经精神评估进行全面回顾，按设施大小分层。专家多学科共识小组确定诊断和适当的治疗。环境：在巴尔的摩市和马里兰州7个县随机选择22个（10个大型和12个小型）人工智能设施。参与者：198名志愿者是AL的居民，75%的人年龄在80岁以上，78%的人是女性。潜在的参与者是根据房间号随机选择的。参与率为67%。测量：痴呆、非认知活动性精神障碍的总体发生率，以及痴呆和精神障碍的识别和适当治疗，由协商一致小组确定。结果：三分之二（67.7%）的参与者根据精神障碍诊断和统计手册第四版（81%的小型机构和63%的大型机构）诊断为痴呆症。家庭或护理人员能识别出78%到80%的痴呆症。73%的痴呆症患者得到了充分的评估，52%的患者得到了充分的治疗。在26.3%患有活动性非认知性精神障碍的参与者中，58%至61%的人得到了识别，52%的人得到了充分的治疗。结论：阿尔茨海默病患者中痴呆和精神障碍较为常见，但其识别率和治疗率均不理想。这可能会导致发病率和干扰居民的能力老化到位。
Objectives: To obtain a direct estimate of the prevalence of dementia and other psychiatric disorders in residents of assisted living (AL) in Central Maryland, and their rates of recognition and treatment.Design: Comprehensive review of history and cognitive and neuropsychiatric evaluations using widely accepted instruments in a randomized cohort of AL residents, stratified by facility size. An expert multidisciplinary consensus panel determined diagnoses and appropriateness of treatment.Setting: Twenty-two (10 large and 12 small) randomly selected AL facilities in the city of Baltimore and seven Maryland counties.Participants: One hundred ninety-eight volunteers who were residents of AL, 75% were aged 80 and older, and 78% were female. Potential participants were randomly chosen by room number. There was a 67% participation rate.Measurements: Overall rate of dementia, noncognitive active psychiatric disorders, and recognition and adequate treatment of dementia and psychiatric disorders, as determined by consensus panel.Results: Two-thirds (67.7%) of participants had dementia diagnosable according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (81% small facilities and 63% large). Family or caregivers recognized 78% to 80% of dementias. Seventy-three percent of dementias were adequately evaluated, and 52% were adequately treated. Of the 26.3% of participants who had an active noncognitive psychiatric disorder, 58% to 61% were recognized and 52% adequately treated.Conclusion: Dementia and psychiatric disorders are common in AL and have suboptimal rates of recognition and treatment. This may contribute to morbidity and interfere with the ability of residents to age in place.