Neuropsychiatric Symptom Clusters of Alzheimer Disease in Hong Kong Chinese: Correlates with Caregiver Burden and Depression
Neuropsychiatric Symptom Clusters of Alzheimer Disease in Hong Kong Chinese: Correlates with Caregiver Burden and Depression
复制标题
DOI：
10.1016/j.jagp.2013.01.041
复制
发表时间：
2013-10-01
影响因子：
7.2
通讯作者：
Kwok, Timothy
中科院分区：
文献类型：
--
作者：
Cheng, Sheung-Tak;Lam, Linda C. W.;Kwok, Timothy
目的：探讨阿尔茨海默病(AD)不同神经精神症状与照顾者负担和抑郁的相关性。方法：采用神经精神病学问卷、修订的记忆与行为问题量表、Zarit负担访谈、皮林氏角色超负荷评定量表、汉密尔顿抑郁量表及其他相关量表(如每周照顾时间、与照顾者的关系、CR的功能损害)对142名AD患者的家庭照顾者进行个别访谈。对CRS进行广东话版的简易智力状态检查。AD的严重程度由临床痴呆评分确定。NPI和RMBPC按症状分类评分(NPI：行为问题、精神病性、情绪障碍、欣快感；RMBPC：破坏性行为、抑郁、记忆相关问题)。数据用多元回归分析，以照顾者性别、每周照看时间和CR的功能损害为协变量。以汉密尔顿抑郁为结果变量的分析还包括Zarit负担和角色过载作为预测因素。结果：NPI行为和NPI情绪对Zarit负担和角色过载有一致的预测作用。RMBPC内存预测了Zarit的负担。没有其他神经精神综合征对负担和超负荷有独立的影响。在剔除负担、超负荷和其他协变量的影响后，NPI行为是唯一能预测照顾者抑郁的症状。结论：并不是所有的神经精神症状都会影响照顾者的负担和抑郁，而明显的行为问题和情绪障碍是负担的一致预测因素。
Objectives: To investigate the relative effects of different neuropsychiatric syndromes of Alzheimer disease (AD) on caregiver burden and depression. Methods: One hundred forty-two Chinese family carers of persons with AD were individually interviewed using Neuropsychiatric Inventory (NPI), Revised Memory and Behavior Problems Checklist (RMBPC), Zarit Burden Interview, Pearlin's measure of role overload, Hamilton Depression Rating Scale, and other relevant measures (e. g., caregiving hours per week, relationship to care recipient [CR], CR's functional impairment). CRs were administered the Cantonese version of the Mini-Mental State Examination. AD severity was determined by Clinical Dementia Rating. NPI and RMBPC items were scored according to syndromal classifications (NPI: behavior problems, psychosis, mood disturbance, euphoria; RMBPC: disruptive behaviors, depression, memory-related problems). Data were analyzed using multiple regression, with caregiver gender, caregiving hours per week, and CR's functional impairment as covariates. The analysis with Hamilton depression as the outcome variable also included Zarit burden and role overload as predictors. Results: NPI behavior and NPI mood were consistent predictors of Zarit burden and role overload. RMBPC memory predicted Zarit burden. No other neuropsychiatric syndromes had independent effects on burden and overload. After partializing out the effects of burden, overload, and other covariates, NPI behavior was the only syndrome that predicted caregiver depression. Conclusions: Not all neuropsychiatric symptoms affected caregiver burden and depression, and overt behavior problems and mood disturbances were consistent predictors of burden.