ABSTRACT
OBJECTIVES: The purpose of this study was to examine the characteristics of Alzheimer's disease (AD) patients living alone and to describe the rate of cognitive and functional impairment after a one-year follow-up. DESIGN AND SETTING: In a prospective longitudinal study conducted by the French network on Alzheimer's disease (the REAL.FR study), 677 older community-dwelling AD patients were interviewed and completed questionnaires and evaluation scales every 6 months during a one-year follow-up. MEASUREMENTS: All patients were assessed by trained staff who collected data on neuropsychological status using the Mini Mental State Examination (MMSE), behavioural disturbances with the Neuropsychiatric Inventory (NPI) and nutritional status with the Mini Nutritional Assessment (MNA). Patients were assessed for current mobility and function in activities of daily living (ADL) and instrumental activities of daily living (IADL). RESULTS: At inclusion, 28% of the 677 non-institutionalised individuals with AD lived alone. Those who lived alone were significantly older than those who did not, and among them the percentage of women was significantly higher. Patients living alone were at increased risk of malnutrition and were more likely to have a low income than those living with others. Persons with AD living alone made greater use of health services. Dementia stage evaluated by cognitive impairment (MMSE) and ADL disabilities was similar in both groups. At one-year follow-up, the mortality rate was significantly higher in AD patients living with others. Institutionalisation and hospitalisation rates were similar. CONCLUSION: These results draw attention to the fact that elderly persons with AD living alone are a subpopulation with specific needs which require the development of targeted interventions. Further investigation of the factors associated with the lower mortality rate in AD patients living alone is necessary, and the results of long-term follow-up in this prospective study should shed light on this question.
Subject(s)
Activities of Daily Living , Alzheimer Disease/psychology , Aged , Cognition Disorders/etiology , Cross-Sectional Studies , Female , Housing , Humans , Longitudinal Studies , MaleABSTRACT
OBJECTIVE: Despite the French population's growing, we reported an increasing numbers of older adults living alone and an increasing number of older adults with Alzheimer's disease. Social and medical problems may be exacerbated with subjects with both phenomena. The objective is to identify differences in patterns between persons with dementia who live alone versus living with some people at home. METHOD: 700 subjects with mild to moderate Alzheimer's disease from the French Alzheimer network (REAL.FR). We studied social and demographic feature, nutritional and cognitive statute and a comprehensive geriatric assessment. RESULTS: In this study, 28% of subjects with probable or possible Alzheimer's disease live alone. They are more likely to be women (p < 0.001) with few physical impairments (p < 0.02). Subject are more frailty: lower incomes, impairment in the nutritional status and balance, and are more likely to use medical and non medical services (p < 0.0001). They are more likely to be malnourished than the others. On the other hand, there is no association between disability's cognitive levels and living alone. CONCLUSION: We need longitudinal survey to follow up this population to determine predicting factors for keeping them alone at home and to anticipate long-term care placement.
Subject(s)
Alzheimer Disease , Residence Characteristics/statistics & numerical data , Aged , Female , France , Humans , Male , Multicenter Studies as TopicABSTRACT
UNLABELLED: The Alzheimer's disease (AD) is today regarded as a degenerative pathology with a serious and common complication: occurrence of mental and behavioral disturbances. Among this neuropsychiatrics symptoms, the depressive symptoms occupy a significant place by their frequency and their consequences on the caregiver's burden. The prevalence of such disorders is very variously appreciated in the literature. OBJECTIVE: To assess with precision depressive symptoms in a population with Alzheimer's disease rated on neuropsychiatric inventory NPI. METHOD: Cross-sectional study of patients with AD presenting at the consultation of psycho-geriatic, geriatric or neurologic services in 16 french university hospitals. The frequency of the depression was evaluated with the NPI on a population of 578 subjects with AD. We studied the association existing between these symptoms and the antecedents of depression and we studied the gravity of these disorders according to the cognitive status. RESULTS: Caregivers describe less one depressive symptom for approximately 40% of the subjects included in the study n = 229. The average score of gravity is close to 4 and is thus clinically significant. More the stage of dementia is severe more the number of subjects presenting a clinically significant score is important. Scores of depression evolve parallel to the stage of dementia. The antecedents of depression are a risk factor for depressive symptoms in the AD p < 0.001. DISCUSSION: These results confirm those of primary studies. In our study, more than the prevalence of depressive symptoms it seems that is the severity of the disorder which is associated with the dementia severity. The continuation of this work will allow a prospective evaluation of depressive symptoms in the AD.
