Systematic reviews on behavioural and psychological symptoms in the older or demented population.
Systematic reviews on behavioural and psychological symptoms in the older or demented population.
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DOI：
10.1186/alzrt131
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发表时间：
2012-07-11
期刊：
影响因子：
--
通讯作者：
Brayne C
中科院分区：
文献类型：
--
作者：
van der Linde RM;Stephan BC;Savva GM;Dening T;Brayne C
痴呆（BPS）的行为和心理症状包括抑郁症状、焦虑、冷漠、睡眠问题、易怒、精神病、徘徊、兴高采烈和躁动，这些症状在非痴呆和痴呆人群中很常见。我们进行了一项系统综述，对老年或痴呆人群中BPS的患病率、病程、生物学和社会心理关联、护理和结局进行了广泛概述，并强调了现有研究中的局限性和差距。使用BPS、痴呆和衰老的搜索词在Embase和Medline上搜索系统综述。确定了36条评论。大多数研究调查了症状的流行程度或病程，而很少有人回顾了BPS对结果和护理的影响。BPS被发现发生在非痴呆、认知受损和痴呆人群中，但报道的估计差异很大。与痴呆患者BPS相关的生物学因素包括遗传因素、同型半胱氨酸水平和血管变化。心理社会因素增加BPS的风险；然而，不同的研究和不同的症状之间的发现是不一致的。BPS与照顾负担、照顾者的一般健康状况和照顾者抑郁评分有关，但在制度化、生活质量和疾病结局方面的研究结果有限。综述的局限性包括缺乏高质量的综述，特别是对抑郁症以外的BPS。原始研究的局限性包括研究设计的异质性，特别是与BPS测量、认知障碍水平、人群特征和参与者招募相关的异质性。我们建议进行更多高质量的综述，包括所有BPS，以及使用经常被引用的工具来测量BPS的更大样本量的纵向研究。更好地了解BPS的风险因素和病程将为预防、治疗和管理提供信息，并可能改善患者及其护理人员的生活质量。
Behavioural and psychological symptoms of dementia (BPS) include depressive symptoms, anxiety, apathy, sleep problems, irritability, psychosis, wandering, elation and agitation, and are common in the non-demented and demented population. We have undertaken a systematic review of reviews to give a broad overview of the prevalence, course, biological and psychosocial associations, care and outcomes of BPS in the older or demented population, and highlight limitations and gaps in existing research. Embase and Medline were searched for systematic reviews using search terms for BPS, dementia and ageing. Thirty-six reviews were identified. Most investigated the prevalence or course of symptoms, while few reviewed the effects of BPS on outcomes and care. BPS were found to occur in non-demented, cognitively impaired and demented people, but reported estimates vary widely. Biological factors associated with BPS in dementia include genetic factors, homocysteine levels and vascular changes. Psychosocial factors increase risk of BPS; however, across studies and between symptoms findings are inconsistent. BPS have been associated with burden of care, caregiver's general health and caregiver depression scores, but findings are limited regarding institutionalisation, quality of life and disease outcome. Limitations of reviews include a lack of high quality reviews, particularly of BPS other than depression. Limitations of original studies include heterogeneity in study design particularly related to measurement of BPS, level of cognitive impairment, population characteristics and participant recruitment. It is our recommendation that more high quality reviews, including all BPS, and longitudinal studies with larger sample sizes that use frequently cited instruments to measure BPS are undertaken. A better understanding of the risk factors and course of BPS will inform prevention, treatment and management and possibly improve quality of life for the patients and their carers.
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