Generalized cognitive impairments, ability to perform everyday tasks, and level of independence in community living situations of older patients with psychosis
Generalized cognitive impairments, ability to perform everyday tasks, and level of independence in community living situations of older patients with psychosis
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DOI：
10.1176/appi.ajp.159.12.2013
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发表时间：
2002-12-01
影响因子：
17.7
通讯作者：
Jeste, DV
中科院分区：
文献类型：
--
作者：
Twamley, EW;Doshi, RR;Jeste, DV
目的：本研究探讨了以加州大学圣地亚哥分校基于表现的技能评估（UPSA）衡量的日常生活工具性活动表现，与老年精神病门诊患者的认知功能及社区生活状况中的独立性之间的关系。
方法：对111名患有原发性精神病的中老年门诊患者进行UPSA、马蒂斯痴呆评定量表以及精神病理学标准化测量。社区生活状况的独立性按1到5分进行评级，5分代表最高水平的独立性，比如独自居住在公寓或房屋中。对67名参与者评估了神经心理功能的七个领域的能力。
结果：加州大学圣地亚哥分校基于表现的技能评估的总分与马蒂斯痴呆评定量表的总分和分量表分数、社区生活状况的独立性水平以及接受神经心理测试的患者亚组中的神经心理测量分数显著相关。马蒂斯痴呆评定量表记忆分量表得分较低以及更严重的阴性症状与技能评估表现较差显著相关。技能评估表现对社区生活状况独立性的预测有独特贡献。
结论：老年精神病患者的广义认知能力与日常功能能力相关。减少认知缺陷和阴性症状可能提高患者在社区中独立生活的能力。
Objective: This study examined the relationship between performance of instrumental activities of daily living, as measured with the University of California, San Diego, Performance-Based Skills Assessment (UPSA), and measures of cognitive functioning and independence in the community living situation of older outpatients with psychotic disorders.Method: One hundred eleven middle-aged and elderly outpatients with primary psychotic disorders were administered the UPSA, the Mattis Dementia Rating Scale, and standardized measures of psychopathology. independence in the community living situation was rated on a scale from 1 to 5, with 5 representing the highest level of independence, such as living alone in an apartment or house. Ability in seven domains of neuropsychological functioning was assessed in 67 participants.Results: Total scores on the University of California, San Diego, Performance-Based Skills Assessment were significantly correlated with total and subscale scores on the Mattis Dementia Rating Scale, level of independence in the community living situation, and scores on the neuropsychological measures in the subset of patients who underwent neuropsychological testing. Lower scores on the Mattis Dementia Rating Scale memory subscale and more severe negative symptoms were significantly associated with worse performance on the skills assessment. Performance on the skills assessment contributed uniquely to prediction of independence in the community living situation.Conclusions: Generalized cognitive abilities are associated with everyday functioning capacity in older patients with psychosis. Reduction of cognitive deficits and negative symptoms may improve patients' ability to function independently in the community.