上海社区阿尔茨海默病行为和精神症状的发生率及影响因素

目的调查上海社区阿尔茨海默病（AD）患者行为和精神症状（BPSD）的发生率及分析可能的相关影响因素。方法对符合美国精神障碍诊断和统计手册第4版（DSM—IV）诊断标准的378例社区AD患者，进行一般资料调查，评定简易智力状态检查（MMSE）、临床痴呆评定表（CDR）及AD病理行为评分表（BEHAVE—AD），分析BPSD症状发生率及有关的影响因素。结果BPSD的发生率为62．2％，其中以行为紊乱发生率最高（35．4％），幻觉及焦虑恐惧最低（均为11．4％），在接受BPSD治疗上仅为20％～25％。重度痴呆的幻觉及行为紊乱的发生率或因子分要高于轻、中度痴呆，而中度痴呆的情感障碍因子分最高。与AD患者BPSD有关的影响因素为病前生活事件、MMSE总分、年龄及CDR评分。结论社区AD患者的BPSD有较高的发生率，与BPSD发生的可能危险因素有生活事件、年龄及认知功能损害程度，需要引起足够的重视。

Research on incidence rate and relative factors of behavioral and psychological symptoms of Alzheimer's disease in communities of Shanghai city

Objective To analyze the incidence rate and relative factors of behavioral and psycho- logical symptoms of dementia （BPSD） in patients with Alzheimer＇s disease （AD） in communities of Shanghai city. Methods Totals of 378 patients with AD living in communities according to the Diagnostic and Statistical Manual of Mental Disorders, the 4th edition （DSM-- IV） were assessed with the general in{ormation questionnaire, including Mini Mental State Examination （MMSE）, Clinic Dementia Rating （CDR） and the Behavioral Pathology in Alzheimer＇s Disease Rating Scale （BEHAVE--AD）. The inci- dence rate and relative factors of BPSD were analyzed. Results The incidence rate of BPSD was 62.2%, among which the behavioral disturbance was the most common （35.4%） symptom, hallucination and anxiety were the lowest （11.4 % ）. Compared with mild and middle AD, hallucination and behavioral dis- turbance were more common in patients with the severe AD, and depression symptom was more common in middle AD （P 〈 0.05）. BPSD was significantly associated with life events, MMSE scores, age and CDR scores （P 〈 0.05）. Conclusions The behavioral and psychological symptoms of community pa tients with AD are common and are strongly associated with life events, age and cognitive decline, which should be paid more attention.