碩士 / 國立成功大學 / 行為醫學研究所 / 100 / Objectives: To develop a feasible, reliable, and valid instrument to evaluate the topographical disorientation (TD) symptoms of the patients with Alzheimer's disease (PwAD) and to monitor the risk factors for getting lost (GL) events and to determine the incidence and recurrence rates of it.
Methods: A longitudinal study of community-dwelling PwAD was performed between April 2009 and March 2012 and encompassing baseline and a 2.5-year follow-up examination. The baseline information was used to establish the reliability and validity of the Questionnaire of Everyday Navigational Ability (QuENA). We focused on new GL events and the associated factors from their demographic data and daily functions by interview, cognitive functions by CASI and MMSE, and behaviors by the QuENA. The study population consisted of 185 PwAD and their co-habitant collaterals. At the baseline, 95 had ever experienced GL (Group B), while and the remaining 90 (Group A) had not.
Results: In the baseline evaluation, the construct validity of QuENA, confirmatory factor analysis showed that the caregiver version of the QuENA fits the proposed TD model well but the patient version does not. Regarding the internal consistency, the Cronbach’s α of the caregiver version was 0.91 and that for the patient version was 0.87. In the follow-up evaluation, 148 (80%) of the participants were interviewed by face to face, and 37 (20%) by telephone; no difference was detected between them in any variable of interest. After a 2.5-year period, 33.3% in the Group A developed GL (incidence) and 40% in the Group B developed GL (recurrence). Multiple logistic regression analysis revealed that inattention on the QuENA and orientation on the CASI had the independent effect on incidence, while being younger and the absence of safety range waved alarm for recurrence. Moreover, during the 2.5 years, PwAD with GL incidence deteriorated more in mental manipulation on CASI than those without.
Conclusions: Cognitive assessment and the QuENA can alarm for the risk of GL incidence. We suggest that once GL occurs, the collaterals of PwAD must take the responsibilities to prevent from the recurrence, in particular for younger patients. In addition, GL may be a behavioral manifestation for subtypes of AD.
| Identifer | oai:union.ndltd.org:TW/100NCKU5666009 |
| Date | January 2012 |
| Creators | Chih-ChienLee, 李志謙 |
| Contributors | Ming-Chyi Pai, 白明奇 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 108 |
Page generated in 0.013 seconds