The Effects of Counseling Spouse Caregivers of People With Alzheimer Disease Taking Donepezil and of Country of Residence on Rates of Admission to Nursing Homes and Mortality

被引：39

作者：

Brodaty, Henry ^{[1
,2
]}

Mittelman, Mary ^{[3
]}

Gibson, Louisa ^{[2
]}

Seeher, Katrin ^{[2
]}

Burns, Alistair ^{[4
]}

机构：

[1] Univ New S Wales, Sch Psychiat, Primary Dementia Collaborat Res Ctr, Sydney, NSW, Australia

[2] Prince Wales Hosp, Acad Dept Old Age Psychiat, Randwick, NSW 2031, Australia

[3] NYU, Sch Med, Dept Psychiat, New York, NY 10003 USA

[4] Univ Manchester, Psychiat Res Grp, Manchester, Lancs, England

来源：

AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY | 2009年 / 17卷 / 09期

关键词：

Caregiver; Alzheimer disease; dementia; nursing home placement; mortality; intervention; POPULATION-BASED COHORT; FAMILY INTERVENTION; BEHAVIOR PROBLEMS; DEMENTIA PATIENTS; CLINICAL-TRIALS; SURVIVAL; PLACEMENT; INSTITUTIONALIZATION; PREDICTORS; OUTCOMES;

D O I：

10.1097/JGP.0b013e3181a65187

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objective: Does psychosocial intervention for caregivers whose spouses with Alzheimer disease (AD) are taking donepezil delay nursing home (NH) placement or death of patients? Design: Randomized controlled trial with 2 years of active treatment and up to 8.5 years of follow-up (mean: 5.4 years, SD: 2.4). Setting: Outpatients of research clinics in Australia, the United Kingdom, and the United States. Participants: One hundred and fifty-five persons with AD and their spouses. Intervention: Five sessions of individual and family counseling (+ prn ad hoc counseling) or usual care. Measurements: Time to institutionalization and death using Cox proportional hazards methods. Results: Over a mean of 5.4 years (SD: 2.4), there were no differences in NH placement or mortality by intervention group, but there were by country, with Australian patients admitted to NHs earlier than U. S. than U. K. patients. Conclusion: Earlier NH admission of Australian compared to U. K. and U. S. subjects may be due to differences in health care, NH systems, availability, and affordability. (Am J Geriatr Psychiatry 2009; 17: 734-743)

引用

页码：734 / 743

页数：10

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