David R. Lee M.D., M.B.A. , Tahmineh Romero M.S. , Katherine Sy Serrano M.P.H. , Michelle Panlilio D.N.P., G.N.P. , Abel Rojas-Parra M.D. , Lauren Matsuno M.D. , Mario F. Mendez M.D., Ph.D. , Christine Willinger M.D., M.P.H. , David B. Reuben M.D.
{"title":"Demographics, Symptoms, Psychotropic Use, and Caregiver Distress in Patients With Early vs Late Onset Dementia","authors":"David R. Lee M.D., M.B.A. , Tahmineh Romero M.S. , Katherine Sy Serrano M.P.H. , Michelle Panlilio D.N.P., G.N.P. , Abel Rojas-Parra M.D. , Lauren Matsuno M.D. , Mario F. Mendez M.D., Ph.D. , Christine Willinger M.D., M.P.H. , David B. Reuben M.D.","doi":"10.1016/j.jagp.2024.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Understanding experiences and challenges faced by persons living with Early-Onset Dementia (EOD) compared to individuals diagnosed with Late-Onset Dementia (LOD) is important for the development of targeted interventions.</p></div><div><h3>Objective</h3><p>Describe differences in sociodemographic, neuropsychiatric behavioral symptoms, caregiver characteristics, and psychotropic use.</p></div><div><h3>Design, Setting, Participants</h3><p>Cross-sectional, retrospective study including 908 UCLA Alzheimer's Dementia Care Program participants (177 with EOD and 731 with LOD).</p></div><div><h3>Measurements</h3><p>Onset of dementia was determined using age at program enrollment, with EOD defined as age <65 years and LOD defined as age >80 years. Sociodemographic and clinical characteristics were measured once at enrollment. Behavioral symptoms were measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score and caregiver distress was measured using the NPI-Q distress score. Medications included antipsychotic, antidepressant, benzodiazepines and other hypnotics, antiepileptics, and dementia medications.</p></div><div><h3>Results</h3><p>EOD compared to LOD participants were more likely men, college graduates, married, live alone, and have fewer comorbidities. EOD caregivers were more often spouses (56% vs 26%, p <0.01), whereas LOD caregivers were more often children (57% vs 10%, p <0.01). EOD was associated with lower odds of being above the median (worse) NPI-Q severity (adjusted odds ratio [aOR], 0.58; 95% CI 0.35–0.96) and NPI-Q distress scores (aOR, 0.53; 95% CI 0.31–0.88). Psychotropic use did not differ between groups though symptoms were greater for LOD compared to EOD.</p></div><div><h3>Conclusion</h3><p>Persons with EOD compared to LOD had sociodemographic differences, less health conditions, and fewer neuropsychiatric symptoms. Future policies could prioritize counseling for EOD patients and families, along with programs to support spousal caregivers of persons with EOD.</p></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1064748124002896/pdfft?md5=f7563899eea2720d1b59875b844ba8f1&pid=1-s2.0-S1064748124002896-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Geriatric Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1064748124002896","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Understanding experiences and challenges faced by persons living with Early-Onset Dementia (EOD) compared to individuals diagnosed with Late-Onset Dementia (LOD) is important for the development of targeted interventions.
Objective
Describe differences in sociodemographic, neuropsychiatric behavioral symptoms, caregiver characteristics, and psychotropic use.
Design, Setting, Participants
Cross-sectional, retrospective study including 908 UCLA Alzheimer's Dementia Care Program participants (177 with EOD and 731 with LOD).
Measurements
Onset of dementia was determined using age at program enrollment, with EOD defined as age <65 years and LOD defined as age >80 years. Sociodemographic and clinical characteristics were measured once at enrollment. Behavioral symptoms were measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score and caregiver distress was measured using the NPI-Q distress score. Medications included antipsychotic, antidepressant, benzodiazepines and other hypnotics, antiepileptics, and dementia medications.
Results
EOD compared to LOD participants were more likely men, college graduates, married, live alone, and have fewer comorbidities. EOD caregivers were more often spouses (56% vs 26%, p <0.01), whereas LOD caregivers were more often children (57% vs 10%, p <0.01). EOD was associated with lower odds of being above the median (worse) NPI-Q severity (adjusted odds ratio [aOR], 0.58; 95% CI 0.35–0.96) and NPI-Q distress scores (aOR, 0.53; 95% CI 0.31–0.88). Psychotropic use did not differ between groups though symptoms were greater for LOD compared to EOD.
Conclusion
Persons with EOD compared to LOD had sociodemographic differences, less health conditions, and fewer neuropsychiatric symptoms. Future policies could prioritize counseling for EOD patients and families, along with programs to support spousal caregivers of persons with EOD.
背景了解早发性痴呆症（EOD）患者与被诊断为晚发性痴呆症（LOD）患者的经历和面临的挑战对于制定有针对性的干预措施非常重要。设计、地点、参与者横断面回顾性研究，包括908名加州大学洛杉矶分校阿尔茨海默氏症痴呆症护理计划参与者（177名EOD患者和731名LOD患者）.测量痴呆症的发病年龄根据计划注册时的年龄确定，EOD定义为65岁，LOD定义为80岁。社会人口学和临床特征在注册时测量一次。行为症状采用神经精神症状量表（NPI-Q）严重程度评分进行测量，照顾者的痛苦采用NPI-Q痛苦评分进行测量。药物包括抗精神病药、抗抑郁药、苯二氮卓类药物和其他催眠药、抗癫痫药和痴呆药。EOD的照顾者更多是配偶（56% vs 26%，p <0.01），而LOD的照顾者更多是子女（57% vs 10%，p <0.01）。EOD与NPI-Q严重程度高于中位数（较差）的几率较低（调整后的几率比 [aOR]，0.58；95% CI 0.35-0.96）和NPI-Q痛苦评分较低（aOR，0.53；95% CI 0.31-0.88）有关。结论与 LOD 相比，EOD 患者在社会人口学方面存在差异，健康状况较差，神经精神症状较少。未来的政策可以优先考虑为 EOD 患者和家属提供咨询，同时为 EOD 患者的配偶照顾者提供支持计划。
期刊介绍：
The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
