PDF(Pubmed)
Abstract：
Dementia can be difficult for married couples for many reasons, including the introduction of caregiving burden, loss of intimacy, and financial strain. In this study, we investigated the impact of dementia staging and neuropsychiatric behavioral symptoms on the likelihood of divorce or separation for older adult married couples. For this case-control study, we used data from the National Alzheimer\'s Coordinating Center (NACC) Uniform dataset (UDS) versions 2 and 3. This dataset was from 2007 to 2021 and contains standardized clinical information submitted by NIA/NIH Alzheimer\'s Disease Research Centers (ADRCs) across the United States (US). This data was from 37 ADRCs. We selected participants who were married or living as married/domestic partners at their initial visit. Cases were defined by a first divorce/separation occurring during the follow-up period, resulting in 291 participants. We selected 5 controls for each married/living as married case and matched on age. Conditional logistic regression estimated the association between overall Neuro Psychiatric Inventory (NPI) score and severity of individual symptoms of the NPI with case/control status, adjusted for education, the CDR® Dementia Staging Instrument score, living situation, symptom informant, sex, and race. Separate analyses were conducted for each symptom. Multiple comparisons were accounted for with the Hochberg method. Later stage of dementia was negatively associated with divorce/separation with an adjusted odds ratio (AOR) = 0.68 (95%CI = 0.50 to 0.93). A higher overall NPI score was positively associated with divorce/separation AOR = 1.08 (95% CI = 1.03 to 1.12,). More severe ratings of agitation/aggression, depression/dysphoria, disinhibition, and elation/euphoria were associated with greater odds of divorce/separation. Among older adults in the US, a later stage of dementia is associated with a lower likelihood of divorce or separation, while having more severe neuropsychiatric behavioral symptoms of agitation/aggression, depression/dysphoria, disinhibition, and elation/euphoria are associated with a higher likelihood of divorce or separation.
摘要：
痴呆症对于已婚夫妇来说可能很困难，原因有很多，包括引入护理负担，失去亲密关系，和财务压力。在这项研究中,我们调查了老年痴呆症分期和神经精神行为症状对成年已婚夫妇离婚或分居可能性的影响.对于这项病例对照研究，我们使用来自国家阿尔茨海默病协调中心（NACC）统一数据集（UDS）版本2和3的数据。该数据集是2007年至2021年的数据集，包含了美国NIA/NIH阿尔茨海默病研究中心（ADRC）提交的标准化临床信息。该数据来自37个ADRC。我们选择了在初次访问时已婚或以已婚/家庭伴侣身份生活的参与者。案件的定义是在随访期间发生的第一次离婚/分居，导致291名参与者。我们为每个已婚/生活者选择了5个对照作为已婚病例，并在年龄上相匹配。条件性逻辑回归估计了总体神经精神病量表（NPI）评分与NPI个体症状严重程度与病例/对照状态之间的关联，适应教育，CDR®痴呆症分期仪器评分，生活状况,症状线人,性别,和种族。对每种症状进行单独分析。用Hochberg方法进行多重比较。晚期痴呆症与离婚/分居呈负相关，调整比值比（AOR）=0.68（95CI=0.50至0.93）。较高的总体NPI评分与离婚/分居AOR=1.08呈正相关（95％CI=1.03至1.12，）。更严重的激动/侵略评级，抑郁/烦躁不安,去抑制,兴高采烈/欣快与离婚/分居的可能性更大。在美国的老年人中，痴呆症的晚期与离婚或分居的可能性较低有关，虽然有更严重的神经精神行为症状的激动/攻击，抑郁/烦躁不安,去抑制,和兴高采烈/欣快与离婚或分居的可能性更高。
