Anxiety Among Older Adults with Dementia in ALFs

描述(由申请人提供)：这项研究的目的是描述生活在辅助生活设施(ALF)中的痴呆症老年患者的焦虑症状。辅助生活正在迅速成为卫生保健连续体的重要组成部分，但在护理和跨学科研究中仍未得到很大程度的研究。在约翰霍普金斯大学进行的马里兰辅助生活(MD-AL)研究结果表明，精神障碍在辅助生活中很普遍：67.7%的老年人患有痴呆症，10%的老年人有其他认知障碍，26.3%的老年人患有非认知精神疾病。人们对ALF中的痴呆症知之甚少，对焦虑症状的了解就更少了。4)这项描述性相关研究的目的是：1)确定生活在ALF中的痴呆症老年患者中焦虑症状以及焦虑和抑郁的患病率；2)确定痴呆症患者中焦虑与其他临床、人口统计学和设施相关变量之间的关系；3)确定非痴呆者中焦虑与其他变量之间的关系；以及4)确定预测生活在ALF中的痴呆症老年患者中焦虑的变量。对居住在社区的老年人的研究表明，焦虑症状很常见，多达70%的痴呆症患者受到影响。痴呆症的焦虑症状会造成痛苦和不适，并伴随着抑郁、更严重的功能障碍、行为症状、生活质量下降和死亡率增加。关于ALF中痴呆症的有限研究表明，行为症状很常见，也是出院到更高水平护理的常见原因。鉴于焦虑症状通常是对环境中令人困惑或不舒服的方面做出反应，并升级为更多的功能障碍和好斗行为，因此需要对ALF中的焦虑进行描述，以在以后开发和测试ALF特有的护理干预措施。MD-AL研究(n=198)的数据将使用描述性和非参数统计以及逻辑回归进行分析，以描述焦虑及其与认知损害、抑郁、功能状态、激动、去抑制、易怒、异常运动行为、精神药物使用以及居民和设施特征的关系。

DESCRIPTION (provided by applicant): The purpose of this study is to characterize anxiety symptoms among older adults with dementia who are living in assisted living facilities (ALFs). Assisted living is rapidly becoming an important part of the health care continuum, but remains largely unstudied in nursing and interdisciplinary research. Results of the Maryland Assisted Living (MD-AL) Study conducted at Johns Hopkins University indicate mental disorders are prevalent in assisted living: 67.7% of older adults had dementia, 10% had other cognitive impairments and 26.3% had non-cognitive psychiatric illness. Little is known about dementia in ALFS, and even less is known about anxiety symptoms. 4 aims of this descriptive correlational study are to 1) determine the prevalence of anxiety symptoms and comorbid anxiety and depression among older adults with dementia living in ALFs; 2) determine the relationship between anxiety and other clinical, demographic, and facility-related variables among those with dementia; 3) determine the relationship between anxiety and other variables among those without dementia; and 4) identify variables that predict anxiety among older adults with dementia living in ALFs. Research with community-dwelling older adults indicates that anxiety symptoms are common, affecting as many as 70% of those with dementia. Anxiety symptoms in dementia create distress and discomfort and are associated comorbid depression, greater functional impairment, behavioral symptoms, reduced quality of life, and increased mortality. Limited research about dementia in ALFs indicates that behavioral symptoms are common, and are a common reason for discharge to a higher level of care. Given that anxiety symptoms often arise in response to confusing or uncomfortable aspects of the environment and escalate into more dysfunctional and combative behaviors, description of anxiety in ALFs is needed to later develop and test ALF-specific nursing interventions. Data from the MD-AL study (n=198) will be analyzed using descriptive and nonparametric statistics and logistic regression to describe anxiety and its relationship to cognitive impairment, depression, functional status, agitation, disinhibition, irritability, aberrant motor behavior, psychotropic medication use, and resident and facility characteristics.