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Yıl:2020; Cilt: 57; Sayı: 2>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2020;57(2):120-125
Üç Demans Tipinde Apatiyi Etkileyen Faktörlerin İncelenmesi
MA Akyol , Ö Küçükgüçlü, G Yener
Dokuz Eylul University, Izmir
Amaç: Apati olumsuz hastalık sonuçları, fonksiyonellikte azalma ve bakım veren yüküne neden olduğu için demansın klinik yönetiminde önemli bir faktördür. Apatiyi yönetilmesi gereken bir problem olarak görmek ve apatiyi etkileyen faktörlerin bilinmesi uygun girişimlerin planlanmasını sağlayacaktır. Bu çalışma, üç demans tipinde apatiyi karşılaştırmak ve her birinde apatiyi etkileyen faktörleri belirlemek için yapılmıştır. Yöntem: Alzheimer hastalığı (AH) olan 46 hasta, Frontotemporal demans (FTD) olan 31 hasta ve vasküler demansı (VD) olan 29 hasta çalışmanın örneklemini oluşturmuştur. Apati, Nöropsikiyatrik Envanter-apati alt ölçeği (NPE), demans evresi Klinik Demans Değerlendirme Ölçeği (KDDÖ), bilişsel durum Mini Mental Test (MMT), işlevsellik Katz Günlük Yaşam Aktiviteleri (GYA) ve Lawton-Brody Enstrümantal Günlük Yaşam Aktivitileri (EGYA) kullanılarak değerlendirilmiştir. Bu araştırma kesitsel ve tanımlayıcı bir çalışmadır. Bulgular: Üç demans tipinde apati puanları arasında anlamlı fark bulunmuştur. AH ve VD’li hastalarda bilişsel fonksiyonlarda azalma ve apati puanı arasında anlamlı bir ilişki olduğu bulunmuştur. Her grupta azalan işlevsellik ve artan demans evresi ile apati puanları arasında anlamlı bir ilişki olduğu bulunmuştur. Yaş, cinsiyet ve apati puanı arasında istatistiksel olarak anlamlı bir ilişki olmadığı bulunmuştur. Çoklu regresyon analizleri sonucu AH’li hastalarda apati puanı ile EGYA puanı arasında korelasyon olduğu bulunmuştur. Sonuç: Bu araştırma apatinin FTD hastalarında olduğu kadar AH ve VD hastalarında da sık görülen bir semptom olduğunu göstermektedir. Sağlık profesyonellerinin apatinin farkında olmaları gerekmektedir. Hastalar demans tipine, yaş ve cinsiyetine bakmaksızın apati açısından değerlendirilmelidir.
Investigation of Factors Affecting Apathy in Three Major Types of Dementia
Introducion: Apathy is an important factor in the clinical management of dementia, as it has been associated with poor disease outcome, reduced daily functioning and caregiver distress. Considering apathy as a problem that needs to be managed and knowing the factors affecting apathy will enable appropriate initiatives to be planned. This study was conducted to compare apathy across three types of dementia and determine the factors affecting apathy for each of the three types of dementia. Methods: The sample consisted of 46 patients with Alzheimer’s disease (AD), 31 patients with frontotemporal dementia (FTD) and 29 patients with vascular dementia (VaD). Apathy was assessed using the Neuropsychiatric Inventory-apathy subscale (NPI), dementia severity was assessed using the Clinical Dementia Rating Scale (CDR), cognitive status was assessed using the Mini Mental Status Examination (MMSE) functional ability was measured with the Katz Index of Independence in Activities of Daily Living (ADL) and the Lawton-Brody Instrumental Activities of Daily Living (IADL). This is a descriptive and cross-sectional study. Results: Significant differences were found between the apathy score of three types of dementia. Cognitive impairment correlated significantly with the apathy score in AD and VaD. Functionality scores and severity of dementia showed a significant correlation with apathy in each group. No statistically significant relationship was detected between age, gender and apathy. Multiple regression analyses show that apathy scores correlated with IADL in patients with AD. Conclusion: This study demonstrated that apathy is very common symptom in patients with FTD as well as patients with AD and VaD. Health professionals need to be aware of recognize apathy. Patients should be assessed for apathy regardless of dementia types, age and gender

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