Anxiety Among Older Adults with Dementia in ALFs

描述（由申请人提供）：本研究的目的是描述生活在辅助生活设施（ALF）中的老年痴呆症患者的焦虑症状。辅助生活正在迅速成为医疗保健连续体的重要组成部分，但在护理和跨学科研究中仍基本未被研究。在约翰霍普金斯大学进行的马里兰州辅助生活（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%患有其他认知障碍，26.3%患有非认知精神疾病。人们对ALFS中的痴呆症知之甚少，对焦虑症状的了解更少。本描述性相关研究的目的是：1）确定生活在ALF中的老年痴呆症患者的焦虑症状和共病焦虑和抑郁的患病率; 2）确定痴呆症患者的焦虑与其他临床，人口统计学和设施相关变量之间的关系; 3）确定非痴呆症患者的焦虑与其他变量之间的关系;以及4）确定预测生活在ALF中的老年痴呆症患者焦虑的变量。对居住在社区的老年人的研究表明，焦虑症状很常见，影响多达70%的痴呆症患者。痴呆症的焦虑症状造成痛苦和不适，并与共病抑郁症、更大的功能障碍、行为症状、生活质量降低和死亡率增加相关。关于ALFs中痴呆症的有限研究表明，行为症状很常见，并且是出院到更高级别护理的常见原因。考虑到焦虑症状往往出现在应对混乱或不舒服的环境方面，并升级为更多的功能失调和好斗的行为，焦虑的描述ALF需要以后开发和测试ALF的具体护理干预措施。将使用描述性和非参数统计和逻辑回归分析MD-AL研究（n=198）的数据，以描述焦虑及其与认知障碍、抑郁、功能状态、激越、抑制解除、易怒、异常运动行为、精神药物使用以及居民和机构特征的关系。

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.