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Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie 2/2007

01-04-2007 | Artikelen

De relatie van psychiatrische functiestoornissen met cognitie, activiteiten dagelijks leven (ADL) en biografische gegevens

Een replicatie-onderzoek op een polikliniek voor cognitieve functiestoornissen

Auteurs: T. J. E. M. Bakker, H. J. Duivenvoorden, J. van der Lee, M. W. Ribbe

Gepubliceerd in: Tijdschrift voor Gerontologie en Geriatrie | Uitgave 2/2007

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Abstract

Psychiatric function disorders: association with cognitive function, activities of daily living and biographical data Background: The prevalence of non-cognitive, psychiatric function disorders (PFD) in psychogeriatric patients, staying in a nursing home is high; it varies from 70 to 80%.
It has a negative impact on the quality of life and life-expectancy. It affects caregiver distress and is an important predictor of permanent admission to an institution. In addition the PFD has predictive potentialities for discharge from reactivation programmes and survival. Although there is a relationship between PFD (measured by NPI) and cognitive function disorders it has to be stated explicitly that from psychiatric point of view these two entities have to be distinguished. This distinction, already been studied by this research group, needed to be replicated in another population.
Objective is to estimate 1) to which degree the prevalence of PFD in psychogeriatric patients, referred to a policlinics for cognitive function disorders (Index condition), differs from community dwelling psychogeriatric patients at referral to clinical and transmural nursing home programmes (Reference condition); 2) to which degree PFD is associated with both cognitive function disorders, activities of daily living for the two conditions; 3) to which degree PFD is associated with relevant general details of the patient, particularly gender, age and marital status, for the two conditions.
Methods: In the Index condition particated patients aged ≥ 65 years suffering from cognitive function disorders (N=70) who were referred to a policlinic for cognitive function disorders who were suspected to suffer from psychiatric function disorders. For 35 patients of them complete data on NPI, MMSE en Barthel Index (BI) were available. In the Reference condition participated patients (age ≥ 65), who were referred to clinical and transmural nursing home programmes and who suffered from cognitive function disorders (MMSE ≥ 29) (N=487). For 385 patients of them all data on NPI, MMSE and BI were available.
Results: Of all patients 92% suffered from at least one NPI symptom; 82% from two or more. Depression, Apathy, Anxiety and Irritability had high prevalences in the two samples. Application of logistic regression analysis for the prediction of total as well as individual NPI-symptoms showed that the prognostic potentialities of MMSE, BI and biographic data were very limited (R2 = 0.11; max.). The non-metric princal component analysis and confirmatory factor analysis of NPI, MMSE and BI for the two samples, showed that MMSE and BI loaded highly on the dimension ‘Cognition’ and NPI on the dimension ‘Psychiatric function disorders’. The dimensional structure of the two samples did not show significant differences.
Conclusion: The dimensional structure of the Index condition highly corresponded to the Reference condition; that is to say that the PFD appeared to be relatively independent of cognition and ADL. High prevalences of PFD (NPI), the broad variance of NPI-symptoms and the limited prognostic importance of MMSE, BI and general details for total NPI-score as well as individual NPI-symptoms were confirmed in both conditions. The dimension ‘Psychiatric function disorder’ was relative independent of the dimension ‘Cognition’. As a result it is of clinical interest - in case of referral to clinical and transmural programmes - to distinguish the psychiatric dimension from the cognitive dimension.
Tijdschr Gerontol Geriatr 2007; 38: 77-87
Literatuur
go back to reference Finkel SI, Burns A. Behavioral and psychological symptoms of dementia (BPSD): a clinical and research update. Int Psychogeriatr 2000; 12 suppl. 1, special issue. Finkel SI, Burns A. Behavioral and psychological symptoms of dementia (BPSD): a clinical and research update. Int Psychogeriatr 2000; 12 suppl. 1, special issue.
go back to reference Beekman ATF, Deeg DJH, Tilburg TG van, Schoevers RA, Smits JH, Hooyer C, Tilburg W van. Depressie bij ouderen in de Nederlandse bevolking. Een onderzoek naar de prevalentie en de risicofactoren. [Depression in the elderly in a Dutch population. A study on prevalence and risk factors]. Tijdschrift voor Psychiatrie 1997; 39, 294-308. Beekman ATF, Deeg DJH, Tilburg TG van, Schoevers RA, Smits JH, Hooyer C, Tilburg W van. Depressie bij ouderen in de Nederlandse bevolking. Een onderzoek naar de prevalentie en de risicofactoren. [Depression in the elderly in a Dutch population. A study on prevalence and risk factors]. Tijdschrift voor Psychiatrie 1997; 39, 294-308.
go back to reference Beekman ATF, Stek ML, Deeg DJH. Het beloop van depressie bij ouderen [The course of depression in elderly patients]. Tijdschrift voor Psychiatrie 1995; 7. Beekman ATF, Stek ML, Deeg DJH. Het beloop van depressie bij ouderen [The course of depression in elderly patients]. Tijdschrift voor Psychiatrie 1995; 7.
go back to reference Teri L, Hughes JP, Pand J, Larson EB. Cognitive deterioration in Alzheimer’s disease: behavioral and health factors. J Gerontol 1990; 45, 58-63. Teri L, Hughes JP, Pand J, Larson EB. Cognitive deterioration in Alzheimer’s disease: behavioral and health factors. J Gerontol 1990; 45, 58-63.
go back to reference Teri L, Borson S, Kiyak A, Yamagashi M. Behavioral disturbance, cognitive dysfunction and functional skill: prevalence and relationship in Alzheimer's disease. JAGS 1989; 37, 109-116. Teri L, Borson S, Kiyak A, Yamagashi M. Behavioral disturbance, cognitive dysfunction and functional skill: prevalence and relationship in Alzheimer's disease. JAGS 1989; 37, 109-116.
go back to reference Sipsma DH. Sociale geriatrie in theorie en praktijk, Almere, Promedia; 1986. Sipsma DH. Sociale geriatrie in theorie en praktijk, Almere, Promedia; 1986.
go back to reference Bakker TJEM, Duivenvoorden HJ, Lee J van der, Schudel WJ. Life-expectancy following Psychogeriatric Reactivation: Identification of prognostic characteristics of survival assessed on admission. Dement Geriatr Cogn Disord 2004; 18(1), 24-31.CrossRefPubMed Bakker TJEM, Duivenvoorden HJ, Lee J van der, Schudel WJ. Life-expectancy following Psychogeriatric Reactivation: Identification of prognostic characteristics of survival assessed on admission. Dement Geriatr Cogn Disord 2004; 18(1), 24-31.CrossRefPubMed
go back to reference Bakker TJEM., Duivenvoorden HJ, Schudel WJ. Psycho-geriatric reactivation in a psychiatric-skilled nursing home; a clinical-empirical exploration. Int J Geriatr Psychiatry 2001; 16, 1-6.CrossRefPubMed Bakker TJEM., Duivenvoorden HJ, Schudel WJ. Psycho-geriatric reactivation in a psychiatric-skilled nursing home; a clinical-empirical exploration. Int J Geriatr Psychiatry 2001; 16, 1-6.CrossRefPubMed
go back to reference Kipling T, Bailey M, Charles-Worth G. The feasibility of a cognitive-behavioral group for men with mild/moderate impairment. Behav Cogn Psychother 1999; 27: 189-93. Kipling T, Bailey M, Charles-Worth G. The feasibility of a cognitive-behavioral group for men with mild/moderate impairment. Behav Cogn Psychother 1999; 27: 189-93.
go back to reference Koder DA. Treatment of anxiety in the cognitive impaired elderly; can cognitive- behavior therapy help? Int Psychogeriatr1998; 10-2: 173-182.CrossRef Koder DA. Treatment of anxiety in the cognitive impaired elderly; can cognitive- behavior therapy help? Int Psychogeriatr1998; 10-2: 173-182.CrossRef
go back to reference Teri L, Gallagher-Thompson D. Cognitive-behavioral interventions for treatment of depression in Alzheimer patients. Gerontologist 1991; 31-3: 413-6.CrossRef Teri L, Gallagher-Thompson D. Cognitive-behavioral interventions for treatment of depression in Alzheimer patients. Gerontologist 1991; 31-3: 413-6.CrossRef
go back to reference Cummings JL, Mega M, Gray K, Rosenberg-Thompson S et al. The neuropsychiatric Inventory, comprehensive assessment of psychopathology in dementia. Neurology 1994; 44, 2308-2314.PubMed Cummings JL, Mega M, Gray K, Rosenberg-Thompson S et al. The neuropsychiatric Inventory, comprehensive assessment of psychopathology in dementia. Neurology 1994; 44, 2308-2314.PubMed
go back to reference Bakker TJEM, Duivenvoorden HJ, Lee J van der, Trijsburg RW. Prevalence of psychiatric function disorders in psychogeriatric patients at referral to nursing home care: the relation to cognition, activities of daily living and general details. Dement Geriatr Cogn Disord 2005; 20 (4), 215-224.CrossRefPubMed Bakker TJEM, Duivenvoorden HJ, Lee J van der, Trijsburg RW. Prevalence of psychiatric function disorders in psychogeriatric patients at referral to nursing home care: the relation to cognition, activities of daily living and general details. Dement Geriatr Cogn Disord 2005; 20 (4), 215-224.CrossRefPubMed
go back to reference Aalten P, Vugt ME de, Jaspers N, Jolles J, Verhey FR. The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study, International J Geriatr Psychiatry 2005a; 20: 523-530.CrossRef Aalten P, Vugt ME de, Jaspers N, Jolles J, Verhey FR. The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study, International J Geriatr Psychiatry 2005a; 20: 523-530.CrossRef
go back to reference Aalten P, Vugt ME de, Jaspers N, Jolles J, Verhey FR.The course of neuropsychiatric symptoms in dementia. Part II: relationships among behavioural sub-syndromes and the influence of clinical variables, Int J Geriatr Psychiatry 2005b; 20: 531-536.CrossRef Aalten P, Vugt ME de, Jaspers N, Jolles J, Verhey FR.The course of neuropsychiatric symptoms in dementia. Part II: relationships among behavioural sub-syndromes and the influence of clinical variables, Int J Geriatr Psychiatry 2005b; 20: 531-536.CrossRef
go back to reference Aalten P, Vugt ME de, Lousberg R. A prospective study into the relationship between premorbid neuroticism and mood disorders and dementia patients (submitted) 2004. Aalten P, Vugt ME de, Lousberg R. A prospective study into the relationship between premorbid neuroticism and mood disorders and dementia patients (submitted) 2004.
go back to reference Aalten P, Vugt ME de, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FR. Behavioral problems in dementia: a factor analysis of the Neuropsychiatric Inventory. Dement Geriatric Cogn Disord 2003a; 15: 99-105.CrossRef Aalten P, Vugt ME de, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FR. Behavioral problems in dementia: a factor analysis of the Neuropsychiatric Inventory. Dement Geriatric Cogn Disord 2003a; 15: 99-105.CrossRef
go back to reference Lyketsos CG, Sheppard JM, Steinberg M, Tschanz JA, Norton MC, Steffens DC, Breitner JC. Neuropsychiatric disturbance in Alzheimer‘s disease clusters in three groups: the Cache County. Int J Geriatr Psychiatry 2001; 16: 1043-1053.CrossRefPubMed Lyketsos CG, Sheppard JM, Steinberg M, Tschanz JA, Norton MC, Steffens DC, Breitner JC. Neuropsychiatric disturbance in Alzheimer‘s disease clusters in three groups: the Cache County. Int J Geriatr Psychiatry 2001; 16: 1043-1053.CrossRefPubMed
go back to reference Wood S, Cummings JL, Hsu M et al. The use of the Neuropsychiatric Inventory in nursing home residence. Characterisation and measurement. Am J Geriatr Psychiatry 2000; 8 (1), 75-83.CrossRefPubMed Wood S, Cummings JL, Hsu M et al. The use of the Neuropsychiatric Inventory in nursing home residence. Characterisation and measurement. Am J Geriatr Psychiatry 2000; 8 (1), 75-83.CrossRefPubMed
go back to reference Kat MG, Jonghe JF de, Aalten P, Kalisvaart CJ, Droes RM, Verhey FR. Neuropsychiatrische symptomen van dementie: psychometrische aspecten van de Nederlandse versie van de Neuropsychiatric Inventory (NPI) [Neuropsychological symptoms in dementia: the psychometric quality of the Dutch version of the Neuropsychiatric Inventory]. Tijdschr Gerontol Geriatr 2002; 33: 150-155.PubMed Kat MG, Jonghe JF de, Aalten P, Kalisvaart CJ, Droes RM, Verhey FR. Neuropsychiatrische symptomen van dementie: psychometrische aspecten van de Nederlandse versie van de Neuropsychiatric Inventory (NPI) [Neuropsychological symptoms in dementia: the psychometric quality of the Dutch version of the Neuropsychiatric Inventory]. Tijdschr Gerontol Geriatr 2002; 33: 150-155.PubMed
go back to reference Pitkala KH, Laurila JV, Strandberg TE, Tilvis RS. Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards. Int Psychogeriatrics 2004; 16, 1, 61-74.CrossRef Pitkala KH, Laurila JV, Strandberg TE, Tilvis RS. Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards. Int Psychogeriatrics 2004; 16, 1, 61-74.CrossRef
go back to reference Brodaty, H., Draper, B., Saab, D., Low, L.F., Richard, V., Paton, H., Lie, D. Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. Int J Geriatr Psychiatry 2001; 16, 504-512.CrossRefPubMed Brodaty, H., Draper, B., Saab, D., Low, L.F., Richard, V., Paton, H., Lie, D. Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. Int J Geriatr Psychiatry 2001; 16, 504-512.CrossRefPubMed
go back to reference Margallo-Lana M, Swann A, O’Brien J, Fairbairn A, Reichelt K, Potkins D, Mynt P, Ballard C. Prevalence and pharmacological management of behavioural and psychological symptoms amongst dementia sufferers living in care environments. Int J Geriatr Psychiatry 2001; 16: 39-44.CrossRefPubMed Margallo-Lana M, Swann A, O’Brien J, Fairbairn A, Reichelt K, Potkins D, Mynt P, Ballard C. Prevalence and pharmacological management of behavioural and psychological symptoms amongst dementia sufferers living in care environments. Int J Geriatr Psychiatry 2001; 16: 39-44.CrossRefPubMed
go back to reference Tariot PN, Podgorski CA, Blazina L, Leibovici A.Mental disorders in the nursing home: Another perspective. Am J Psychiatry 1993; 150-.7, 1063-1069.PubMed Tariot PN, Podgorski CA, Blazina L, Leibovici A.Mental disorders in the nursing home: Another perspective. Am J Psychiatry 1993; 150-.7, 1063-1069.PubMed
go back to reference Aalten, P., de Vugt, M.E., Verhey, F.R. Gedragsstoornissen bij dementiepatiënten: de Maasbed-studie [Behavioural problems in dementia; the Maasbed study]. Tijdschrift voor verpleeghuisgeneeskunde 2003b; 27:5, 33-36. Aalten, P., de Vugt, M.E., Verhey, F.R. Gedragsstoornissen bij dementiepatiënten: de Maasbed-studie [Behavioural problems in dementia; the Maasbed study]. Tijdschrift voor verpleeghuisgeneeskunde 2003b; 27:5, 33-36.
go back to reference Tran M, Bédard M, Moloy W, Dubois S, Lever JA. Associations between psychotic symptoms and dependence in activities of daily living among older adults with Alzheimer’s disease. Int Psychogeriatr 2003; 15, 2, 171-179.CrossRefPubMed Tran M, Bédard M, Moloy W, Dubois S, Lever JA. Associations between psychotic symptoms and dependence in activities of daily living among older adults with Alzheimer’s disease. Int Psychogeriatr 2003; 15, 2, 171-179.CrossRefPubMed
go back to reference Folstein MF, Folstein, SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198.CrossRefPubMed Folstein MF, Folstein, SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198.CrossRefPubMed
go back to reference Haan R de, Liburg M, Schuling J, Broeshart J, Jonkers L, Zuylen P van. Klinimetrische evaluatie van de Barthel-index, een maat voor beperkingen in het dagelijks functioneren [Clinimetric evaluation of the Barthel Index, as a measure of activities of daily living]. Ned Tijdschr Geneesk 1993; 18, 917-921. Haan R de, Liburg M, Schuling J, Broeshart J, Jonkers L, Zuylen P van. Klinimetrische evaluatie van de Barthel-index, een maat voor beperkingen in het dagelijks functioneren [Clinimetric evaluation of the Barthel Index, as a measure of activities of daily living]. Ned Tijdschr Geneesk 1993; 18, 917-921.
go back to reference Nagelkerke NJD. A note on general definition of the coefficient of determination. Biometrika, 1991, 78, 691-692.CrossRef Nagelkerke NJD. A note on general definition of the coefficient of determination. Biometrika, 1991, 78, 691-692.CrossRef
go back to reference Gifi A. PRINCALS. Leiden: dept. Data Theory, University of Leiden, 1985. Gifi A. PRINCALS. Leiden: dept. Data Theory, University of Leiden, 1985.
go back to reference Gifi A. Nonlinear multivariate analysis. Leiden: dept. Data Theory, University of Leiden, 1981. Gifi A. Nonlinear multivariate analysis. Leiden: dept. Data Theory, University of Leiden, 1981.
go back to reference Leeuw J. de, Rijckevorsel J van. HOMALS and PRINCALS; some generalisations of principal component analysis. In: E. Diday et al. (ed.). Data analysis and informatics. Amsterdam: North-Holland, 1980. Leeuw J. de, Rijckevorsel J van. HOMALS and PRINCALS; some generalisations of principal component analysis. In: E. Diday et al. (ed.). Data analysis and informatics. Amsterdam: North-Holland, 1980.
go back to reference Beekman AFT, Geerlings SW, Deeg DJH, Smit JH, Schoevers RS, Beurs E de, Braam AW, Penninx, BWJH, Tilburg W van. Het beloop van depressie bij ouderen; resultaten van 6 jaar intensieve follow-up. [The course of depression in the elderly; results of 6 year follow-up study]. Tijdschrift voor Psychiatrie, 2004; 46, 73-83. Beekman AFT, Geerlings SW, Deeg DJH, Smit JH, Schoevers RS, Beurs E de, Braam AW, Penninx, BWJH, Tilburg W van. Het beloop van depressie bij ouderen; resultaten van 6 jaar intensieve follow-up. [The course of depression in the elderly; results of 6 year follow-up study]. Tijdschrift voor Psychiatrie, 2004; 46, 73-83.
go back to reference Diesfeldt HFA. Moeilijk hanteerbaar gedrag en psychologische interventies, Tijdschr Gerontol Geriatr 2005; 36, 7, 98-99.PubMed Diesfeldt HFA. Moeilijk hanteerbaar gedrag en psychologische interventies, Tijdschr Gerontol Geriatr 2005; 36, 7, 98-99.PubMed
go back to reference Dautzenberg P, Wouters C, Jonghe J de. Medicamenteuze behandeling van gedrag en psychische problemen bij dementie (BPSD) [Medicamental treatment of behavioural and psychological symptoms in dementia (BPSD)]. Tijdschrift voor Verpleeghuisgeneeskunde 2003; 27; 5, 5-9. Dautzenberg P, Wouters C, Jonghe J de. Medicamenteuze behandeling van gedrag en psychische problemen bij dementie (BPSD) [Medicamental treatment of behavioural and psychological symptoms in dementia (BPSD)]. Tijdschrift voor Verpleeghuisgeneeskunde 2003; 27; 5, 5-9.
go back to reference Scholey KE, Woods BT. A series of brief cognitive therapy interventions with people experiencing both dementia and depression: a description of techniques and common themes. Clin Psychol Psychother 2003; 10, 175-185.CrossRef Scholey KE, Woods BT. A series of brief cognitive therapy interventions with people experiencing both dementia and depression: a description of techniques and common themes. Clin Psychol Psychother 2003; 10, 175-185.CrossRef
go back to reference Smalbrugge M, Pot AM, Jongenelis K, Beekman ATF, Eefsting JA. Angststoornissen bij verpleeghuisbewoners: een literatuuronderzoek naar prevalentie, beloop en risicofactoren [Anxiety disorders in nursing home patients: a study of literature on prevalence, course and risk factors]. Tijdschr Gerontol Geriatr 2003; 34, 215-221.PubMed Smalbrugge M, Pot AM, Jongenelis K, Beekman ATF, Eefsting JA. Angststoornissen bij verpleeghuisbewoners: een literatuuronderzoek naar prevalentie, beloop en risicofactoren [Anxiety disorders in nursing home patients: a study of literature on prevalence, course and risk factors]. Tijdschr Gerontol Geriatr 2003; 34, 215-221.PubMed
go back to reference Legra MJH, Bakker TJEM. Rationeel-emotieve therapie in de psychogeriatrie: een nieuwe toepassing? [Rational-emotive theray in psychogeriatrics; a new field of application?]. Tijdschr Gerontol Geriatr 2002; 33, 101-106.PubMed Legra MJH, Bakker TJEM. Rationeel-emotieve therapie in de psychogeriatrie: een nieuwe toepassing? [Rational-emotive theray in psychogeriatrics; a new field of application?]. Tijdschr Gerontol Geriatr 2002; 33, 101-106.PubMed
go back to reference Gerson S, Belin TR, Kaufman A, Mintz J, Jarvik L. Pharmalogical and psychological treatments for depressed older patients: a meta-analysis and overview of recent findings. Harvard Rev Psychiatry 1999; 7, 1-28.CrossRef Gerson S, Belin TR, Kaufman A, Mintz J, Jarvik L. Pharmalogical and psychological treatments for depressed older patients: a meta-analysis and overview of recent findings. Harvard Rev Psychiatry 1999; 7, 1-28.CrossRef
Metagegevens
Titel
De relatie van psychiatrische functiestoornissen met cognitie, activiteiten dagelijks leven (ADL) en biografische gegevens
Een replicatie-onderzoek op een polikliniek voor cognitieve functiestoornissen
Auteurs
T. J. E. M. Bakker
H. J. Duivenvoorden
J. van der Lee
M. W. Ribbe
Publicatiedatum
01-04-2007
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Gerontologie en Geriatrie / Uitgave 2/2007
Print ISSN: 0167-9228
Elektronisch ISSN: 1875-6832
DOI
https://doi.org/10.1007/BF03074830

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