背景:患有精神障碍的老年人数量正在增加,但是很少有研究关注这些患者的身体状况和日常生活活动(ADL)。这项研究旨在描述来自不同年龄段的精神疾病(PMI)患者的身体状况和ADL,这为改善PMI的精神卫生服务提供了证据。
方法:在这项前瞻性横断面研究中,将样本分为三组,年龄小于60岁(第1组),60-74岁(第2组),和75岁以上(第3组)进行比较。参与者的ADL和身体状况用Barthel指数(BI)衡量,功能活动问卷(FAQ),标准化吞咽评估(SSA)和简短的迷你营养评估(MNA-SF)。简明精神病量表(BPRS)和简易精神状态检查(MMSE)用于测量心理状况。
结果:完全,招募了392名参与者,与此同时,86%的人被诊断出至少一种身体疾病。3组受试者的BI差异有统计学意义(F=50.603,P<0.001),常见问题解答(F=40.332,P<0.001),SSA(F=28.574,P<0.001),MNA-SF(F=18.366,P<0.001)。第2组和第3组的BI和FAQ得分明显低于第1组,SSA得分明显高于第1组。在BPRS阴性症状量表中,第3组的平均评分明显高于第1组和第2组.阴性症状分量表与BI有不同程度的相关性(r=-0.537),FAQ(r=0.643),SSA(r=0.480),MNA(r=-0.325)和MMSE(r=0.607)。此外,有合并症的参与者与BI相关(r=-0.364).
结论:躯体合并症在老年精神病患者的临床特征中起着举足轻重的作用。因此,应该为患有吞咽困难的精神疾病的老年患者付出更大的努力,营养不良,和认知能力下降。Further,老年精神障碍患者的阴性症状也值得关注。
BACKGROUND: The number of elderly with mental disorders is increasing, but few studies have been concerned with the physical condition and activities of daily living (ADL) of these patients. This study aims to describe the physical condition and ADL of patients with mental illnesses (PMI) from different age groups, which provides evidence to improve mental health services for PMI.
METHODS: In this prospective cross-sectional study, the samples were divided into three groups of less than 60 years old (group 1), 60-74 years old (group 2), and over 75 years old (group 3) for comparison. Participants\' ADL and physical condition were measure by Barthel Index (BI), Functional Activities Questionnaire (FAQ), Standardised swallowing assessment (SSA) and Short Form of Mini Nutrition Assessment (MNA-SF). The Brief Psychiatric Rating Scale (BPRS) and the Mini-Mental State Examination (MMSE) were used to measure psychological condition.
RESULTS: Totally, 392 participants had been recruited, meanwhile 86% of them were diagnosed with at least one physical disease. There were statistically significant differences in the three groups of participants in BI (F = 50.603, P < 0.001), FAQ (F = 40.332, P < 0.001), SSA (F = 28.574, P < 0.001), and MNA-SF (F = 18.366, P < 0.001). Group 2 and group 3 had significantly lower scores in BI and FAQ than group 1, and the SSA scores were significantly higher than the participants in group 1. In the negative symptoms subscale of BPRS, the mean score of group 3 was significantly higher than groups 1 and 2. Negative symptom subscale has different degrees of correlation with BI (r = -0.537), FAQ (r = 0.643), SSA (r = 0.480), MNA (r = -0.325) and MMSE (r = 0.607). In addition, the participants with comorbidities were related to BI (r = -0.364).
CONCLUSIONS: Somatic comorbidities play a pivotal role in the clinical characteristics of elderly patients with mental illness, thus greater effort should be paid to elderly patients suffering from mental illness with dysphagia, malnutrition, and cognitive decline. Further, the negative symptoms of elderly patients with mental disorders also deserve attention.