Premium
The role of psychosocial factors in the formation of non‐cognitive symptoms of dementia
Author(s) -
Sidenkova Alena Petrovna
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.047609
Subject(s) - dementia , psychosocial , clinical psychology , psychology , irritability , psychiatry , clinical dementia rating , mood , cognition , anxiety , medicine , disease , cognitive impairment
Background The non‐cognitive symptoms actualize a comprehensive medical and social study of dementia. The aim of the study is to study the psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementia. Method A selective observational comparative dynamic study of 315 people with dementia of the Alzheimer's and 214 of the patients was carried out. The study used clinical, clinical, neuropsychological, sociometric, and statistical research methods. Result An increase in the severity of dementia contributes to a significant (p <0.05) increase in the number of patients in a dependent position in the family. The appearance of psychotic (painful ideas [r = 0.589]), behavioral (agitation / aggression [r = 0.654]), affective (anxiety [r = 0.536], unstable mood / irritability [r = 0.581]) symptoms of dementia contribute to family role changes structure and increase interpersonal distance in the dyad "caretaker ‐ patient." Those who provide unprofessional care for dementia patients in a statistically significant (p <0.05) majority of cases have a high level of emotional involvement in the care process. Changes in family‐role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti‐dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation / aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver. Conclusion The formation of cognitive impairment is due to biological causes, their severity depends on the severity of dementia. The mechanism of psychopathological symptoms, functional disorders is heterogeneous depending on the biological causes and psychosocial conditions of functioning of patients.