Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5-year prospective ALSOVA cohort study
Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5-year prospective ALSOVA cohort study
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DOI：
10.1002/gps.4666
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Koivisto, Anne M.
中科院分区：
文献类型：
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作者：
Hongisto, Kristiina;Hallikainen, Ilona;Koivisto, Anne M.
目的探讨阿尔茨海默病（AD）患者5年随访期间的神经精神症状（ADL）与自评和自评生活质量（QoL）之间的关系。（临床痴呆评定量表（CDR）0.5）或轻度（CDR 1）AD的患者及其来自三个芬兰医院区的护理人员。使用患者自我报告和患者评分的AD生活质量（QoL-AD）评分评价生活质量。使用神经精神量表（NPI）评估AD，使用CDR评估AD严重程度，使用简易精神状态检查测试认知。日常活动的性能进行了评估，使用阿尔茨海默病合作研究活动的日常生活Inventory.ResultsOver 5年的随访期间，患者自我报告的生活质量-AD评分没有显着变化（p=0.245），尽管他们的生活质量增加。然而，随着随访期间总NPI评分增加，患者QoL-AD评分显著下降（p <0.001）。在基线时无焦虑，随访时仅有冷漠，与患者自评QoL-AD评分显著相关（p=0.007）。护理人员评定的患者生活质量-AD评分与大多数NPS显着相关，尤其是（p0.001）基线时的冷漠、激越、焦虑、易怒、抑郁和妄想，以及随访期间的妄想、幻觉、冷漠、食欲障碍和焦虑。结论患者评定的生活质量-AD评分是评估NPS治疗成功的不可靠工具。相反，患者的无障碍评分与NPI评分相关性很好，诊所的医疗保健专业人员应优先使用这些评分。版权所有（c）2017约翰威利父子有限公司
ObjectiveTo examine the association between neuropsychiatric symptoms (NPS) with self- and caregiver-rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5-year follow-up.MethodsThe ALSOVA 5-year follow-up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self-reported, and caregiver-rated, QoL in AD (QoL-AD) scores. NPS were assessed using the Neuropsychiatric Inventory (NPI), and AD severity was evaluated using the CDR, with cognition tested by the mini-mental state examination. The performance of daily activities was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory.ResultsOver the 5-year follow-up period, patient self-reported QoL-AD scores did not change significantly (p=0.245), despite increases in their NPS. However, caregiver-rated patient QoL-AD scores declined significantly (p0.001), as total NPI scores increased during follow-up. No NPS at baseline, and only apathy at follow-up, correlated significantly (p=0.007) with patient self-rated QoL-AD scores. Caregiver-rated patient QoL-AD scores correlated significantly with most NPS, especially (p0.001) apathy, agitation, anxiety, irritability, depression, and delusions at baseline, and delusions, hallucinations, apathy, appetite disturbances, and anxiety during follow-up.ConclusionsPatient rated QoL-AD scores are an unreliable tool with which to evaluate the success of therapy for NPS. Instead, caregiver-rated scores for patients correlated well with NPI scores, and health care professionals in the clinic should preferentially use these. Copyright (c) 2017 John Wiley & Sons, Ltd.