Dementia Caregiver Burden: a Research Update and Critical Analysis.
Dementia Caregiver Burden: a Research Update and Critical Analysis.
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DOI：
10.1007/s11920-017-0818-2
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发表时间：
2017-08-10
影响因子：
6.7
通讯作者：
Cheng ST
中科院分区：
文献类型：
--
作者：
Cheng ST
本文对照顾者负担和抑郁的决定因素进行了最新的综述，重点是护理需求，特别是各种神经精神症状或症状组的不同影响。此外，为了确定与主要基于阿尔茨海默病照顾者的主流文献的不同和相似之处，参考了关于额颞部和路易体痴呆照顾者的研究。作为一个群体，神经精神症状最能预测照顾者的负担和抑郁，无论诊断为痴呆症，但其影响似乎主要是由破坏性行为(例如，激动、攻击、去抑制)驱动的，其次是妄想和情绪障碍。破坏性行为更令人不安，部分原因是对照顾者和接受者之间的情感联系产生不利影响，部分原因是它们加剧了其他领域的困难(例如，照顾日常生活活动)。在行为变异型额颞叶痴呆中，这些破坏性行为不仅更加突出，而且由于受照顾者对他人的感受不敏感，它们也更令人不安。在路易体痴呆症中，视觉幻觉似乎也令人痛苦。破坏性行为的令人不安的性质跨越了痴呆症的情况，但在某种情况下独特或特别严重的症状所起的作用需要进一步探讨。
This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers. As a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disruptive behaviors (e.g., agitation, aggression, disinhibition), followed by delusions and mood disturbance. Disruptive behaviors are more disturbing partly because of the adverse impact on the emotional connection between the caregiver and the care-recipient and partly because they exacerbate difficulties in other domains (e.g., caring for activities of daily living). In behavioral variant frontotemporal dementia, not only are these disruptive behaviors more prominent but they are also more disturbing due to the care-recipient’s insensitivity to others’ feelings. In Lewy body dementia, visual hallucinations also appear to be distressing. The disturbing nature of disruptive behaviors cuts across dementia conditions, but the roles played by symptoms that are unique or particularly serious in a certain condition need to be explored further.
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影响因子：
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作者：
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通讯作者：
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