阿尔茨海默病患者首发精神行为症状分析及影响因素

Analysis of initial behavioral and psychological symptoms of dementia in patients with Alzheimer disease and their influencing factors

摘要:

目的 探讨阿尔茨海默病（AD）患者首发精神行为症状（BPSD）的发生情况及其人口学影响因素。方法 纳入2021年1月至2024年10月就诊于成都市第四人民医院记忆门诊的AD患者517例，通过自制问卷及量表采集信息并进行统计分析。结果 AD患者首发BPSD中，妄想最为常见（48.16%），其后依次为情绪障碍（43.52%）、行为障碍（28.82%）和幻觉（23.60%），37.72%的患者首发症状不止一种。男性AD患者首发妄想比例较低，而首发行为障碍比例较高（P<0.05）；有配偶者首发妄想比例较低（P<0.05）。多因素Logistic回归分析显示，男性可能是首发妄想的保护因素，文盲及无配偶可能是情绪障碍的保护因素，男性及文盲可能是行为障碍的危险因素。结论 AD患者首发BPSD以妄想最为常见，且人口学因素对首发症状类型存在独立影响。提示在AD早期评估中，应关注不同人群的首发精神行为特征，为早期识别与个体化干预提供依据。

Abstract:

Objective To investigate the occurrence of the initial behavioral and psychological symptoms of dementia （BPSD） and their demographic influencing factors in patients with Alzheimer disease （AD）.Methods A total of 517 patients with AD who visited the Memory Clinic of The Fourth People's Hospital of Chengdu between January 2021 and October 2024 were included. Data were collected using self-designed questionnaires and scales， followed by statistical analysis.Results Among the initial BPSD in AD patients， delusions were the most common （48.16%）， followed by emotional disorders （43.52%）， behavioral disorders （28.82%）， and hallucinations （23.60%）. Of the patients， 37.72% presented with more than one initial BPSD. Male patients with AD had a relatively low proportion of initial delusions and a relatively high proportion of initial behavioral disorders （P<0.05）， while patients with a spouse had a relatively low proportion of initial delusions （P<0.05）. Multivariate logistic regression analysis showed that male sex might be a protective factor for initial delusions， illiteracy and absence of a spouse might be protective factors for emotional disorders， and male sex and illiteracy might be risk factors for behavioral disorders.Conclusions Delusions are the most common initial BPSD in patients with AD， and demographic factors have independent effects on the type of initial BPSD. These findings suggest that， during early assessment of AD， attention should be paid to the characteristics of initial BPSD in different populations， so as to provide a foundation for early identification and personalized intervention.