Behavioral Disturbance & Caregiver Distress in Dementia

在痴呆症的过程中，行为障碍是常见的。行为障碍的病因很可能是生物和心理社会因素复杂相互作用的结果。国际比较研究通过提供各种各样的社会和环境经验，在阐明这些因素方面提供了独特的优势。印第安纳波利斯伊巴丹痴呆症项目(IIDP)是一项基于人口比较的纵向研究，研究对象是来自尼日利亚伊巴丹印第安纳波利斯、印第安纳和约鲁巴的非裔美国人的痴呆症。到目前为止，该项目已经确定，约鲁巴人的阿尔茨海默病和痴呆症的发病率明显低于非裔美国人。然而，与痴呆症相关的行为障碍是这两个地点患者和照顾者痛苦的主要来源。这项建议的目的是扩大IIDP以更深入地研究痴呆症的行为障碍 通过对两个地点的痴呆症受试者和照顾者实施神经精神病学问卷(NPI)，并通过分析现有的临床、遗传和心理社会数据来确定行为障碍的风险因素，并设计一个问题来探索两个地点的照顾者特征，从而确定人群和照顾者痛苦中的受试者。这项研究的具体目的是：1)通过使用NPI来比较老年非裔美国人和老年约鲁巴人行为障碍的频率和严重程度。2)使用NPI量表比较两组痴呆患者照顾者的痛苦程度。3)确定与AD的行为功能障碍和照顾者痛苦相关的危险因素 使用已经作为II研究的一部分收集的临床、神经心理、遗传和心理社会数据。4)设计调查问卷，更深入地探索两个地点的照顾者特征。为此目的，将使用现有调查表中的项目，并进行统一和试点测试。从这项初步研究中收集的数据将被用来设计一个更全面的建议，以评估痴呆症行为障碍的风险因素，以及两个人群中照顾者的反应，并设计可能的干预措施。

Behavioral disturbances occur commonly in the course of dementia. The etiology of behavioral disturbances is likely to be the result of complex interactions of biological and psychosocial factors. International comparative studies offer unique advantages in elucidating these factors by providing a wide diversity of social and environmental experiences. The Indianapolis Ibadan Dementia Project (IIDP) is a well-established longitudinal comparative population based study of dementia in African Americans from Indianapolis, IN and Yoruba in Ibadan, Nigeria. To date, the project has determined that the incidence rates for AD and dementia were significantly lower in Yoruba than in African Americans. Nevertheless, behavioral disturbances associated with dementia are a major source of distress for patients and caregivers at both sites. The purpose of this proposal is to expand the IIDP to study more intensely behavioral disturbance in demented subjects in both populations and caregiver distress by administering the Neuropsychiatric Inventory (NPI) to demented subjects and caregivers at both sites and to determine risk factors for behavioral disturbances by analyzing already existing clinical genetic and psychosocial data and to design a question to explore caregiver characteristics at both sites. The Specific Aims of the study are: 1)To compare the frequency and severity of behavioral disorder in elderly African American and elderly Yoruba subjects by administering the NPI. 2)To compare the severity of distress in caregivers of demented subjects between the two populations using the NPI. 3)To identify risk factors associated with behavioral dysfunction of AD and caregiver distress using the clinical, neuropsychological genetic and psychosocial data already collected as part of the II study. 4)To design a questionnaire to explore in more depth caregiver characteristics at both sites. For this purpose items from existing questionnaires will be used and subject to the process of harmonization and pilot testing. The data gathered from this pilot study will be used to design a more comprehensive proposal to evaluate risk factors for behavioral disturbance in dementia, caregiver response in two populations and to design possible interventions.