目的 探讨阿尔茨海默病(Alzheimer's disease,AD)患者精神行为症状(Behavior and psychological symptom of dementia,BPSD)发生情况及影响因素分析.方法 观察对象为2019年5月～2024年5月85例AD患者,通过对家属进行神经精神科问卷(Neuropsychiatric inventory questionnaire,NPI-Q)调查了解BPSD发生情况,调查年龄、性别、病程等病历资料并进行BPSD影响因素单因素分析以及多因素分析.结果 85例AD患者中,34例(40％)具有BPSD,其中表现为1种BPSD症状的有5例,2种有7例,3种及以上有22例;AD患者是否发生BPSD与年龄、居住情况、睡眠情况、AD严重程度、AD病程、脑白质信号、居住地、糖尿病、高血压等方面具有显著性关联(P＜0.05),与血脂、性别、学历、婚姻方面无显著性关联(P＞0.05);单因素逻辑回归分析显示,高龄、独居、睡眠障碍、严重AD、AD病程长、脑白质高信号、居住地农村、合并糖尿病分别是AD患者并发BPSD的影响因素(P＜0.05);多因素逻辑回归分析显示,年龄＞80岁、独居、睡眠障碍、脑白质重度高信号、重度AD是AD患者BPSD的风险因素.结论 BPSD在AD患者中较为常见,高龄、独居等会增加BPSD发生风险,临床应重视高危患者BPSD的防治.
Analysis of the Occurrence and Influential Factors of Psychobehavioral Symptoms in Patients with Alzheimer's Disease
Objective To investigate the occurrence of Behavior and psychological symptoms of dementia(BPSD)in patients with Alzheimer's disease(AD)and their influential factors.Methods The observation subjects were Eighty-five AD patients from May 2019 to May 2024.The occurrence of BPSD was investigated by administering the Neuropsychiatric inventory questionnaire(NPI-Q)to the family members.Medical records such as age,gender,and duration of disease were extracted and univariate analysis and logistic regression analysis were performed.Results Of the 85 AD patients,34 had BPSD,including 5 patients with 1 type of BPSD,7 patients with 2 types,and 22 patients with 3 or more types.Univariate analysis showed that there was a significant difference in the information of age,residence,sleep status,AD severity,duration of AD,cerebral white matter signal,place of residence,diabetes mellitus,and hypertension in AD patients with or without BPSD(P＜0.05).There was no significant difference in hyperlipidemia,gender,education,and marriage(P＞0.05).Univariate logistic regression analysis showed that old age,living alone,sleep disorder,severe AD,long-course AD,white matter hypersignal,rural place of residence,combined diabetes were independent influential factors for AD patients with BPSD(P＜0.05).Multifactorial analysis showed that age＞80 years,living alone,sleep disorders,severe white matter high signal,and severe AD were the risk factors of BPSD in AD patients.Conclusion BPSD is common in AD patients.Old age and living alone increase the risk of BPSD.Clinical attention should be paid to the prevention and treatment of BPSD in high-risk patients.
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