阿尔兹海默病患者精神行为症状的潜在类别及其影响因素 [中文引用][英文引用]

目的  探讨阿尔兹海默病（Alzheimer’s disease，AD）患者精神行为症状的潜在类别及其影响因素，为制订个性化护理措施提供依据。方法  采用便利抽样法，选取 2023 年 11 月至 2024 年 5 月于本院神经内科住院的 361 例 AD 患者为调查对象，采用一般资料调查表、神经精神科问卷知情者版（neuropsychiatric inventory questionnaire，NPI-Q）、蒙特利尔认知评估量表（Montreal cognitive assessment scale，MoCA）、日常生活能力量表（activity of daily life scale，ADL）、微型营养评定量表（mininutritional assessment，MNA）进行调查，采用潜在类别分析探讨 AD 患者精神行为症状的潜在类别，采用单因素分析与无序多分类 Logistic 回归分析患者精神行为症状潜在类别的影响因素。结果  346 例 AD 患者完成研究。72.5% 的 AD 患者存在精神行为症状；患者分为“症状低发 - 情感淡漠组、症状中发 - 情绪障碍组、症状高发 - 行为异常组”3 个潜在类别。病程、认知功能、日常生活能力、营养状况是 AD 患者精神行为症状潜在类别的影响因素（均 P<0.05）。结论  AD 患者精神行为症状存在群体异质性，医护人员应重点关注低认知功能、低日常生活能力、存在营养不良、病程超过 5 年的 AD 患者，并结合症状特征和原因，制订个性化护理措施，以改善 AD 患者精神行为症状。

Objective To explore latent classes of behavioural and psychological symptoms in the patients with Alzheimer's disease（AD）and to identify the factors influencing the latent classes and provide a basis for fomulating personalized nursing measures. Methods Convenience sampling was employed to recruit 361 AD inpatients from our hospital between November 2023 and May 2024 for this cross-sectional study. A general data questionnaire，the neuropsychiatric inventory questionnaire，Monteria cognitive assessment scale，activity of daily life scale，and mini-nutritional assessment scale were used in the survey. Latent class analysis was conducted to analyse the data acquired from the survey. Univariate analysis and multiple Logistic regression analysis were used to identify the factors influencing latent classes. Results Toally 346 patients finished the study. It was found that a 72.5% of AD patients developed behavioural and psychological symptoms. The symptoms were categorised into three classes：low symptom-apathy，middle symptomemotional disturbance and high symptom-behaviour disorder. The course of disease，cognitive function，daily living ability and nutritional status were identified as the factors that influenced the latent classes（all P<0.05）. Conclusion AD patients with low cognitive function，poor daily living ability，malnutrition and a course of disease over 5 years are at high risks of behavioural and psychological symptoms which are heterogeneous. Care providers are advised to propose personalised care strategies to improve the behavioural and psychological symptoms.