终末期肾病患者功能状态与认知障碍的关系

A. Arman, M. Yaseen, Tahir Ansari, Natasha Billia, M. Butt
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摘要

【摘要】目的:第三世界国家糖尿病、高血压发病率的增加导致终末期肾脏疾病的增加,这反过来又增加了患者和护理人员的透析负担。透析与许多严重的身体和精神障碍有关。本研究的目的是强调在终末期肾脏疾病中筛查认知障碍和抑郁的重要性,因为认知障碍会损害日常生活活动和整体生活质量。方法:150例患者在满足纳入和排除标准后纳入研究。使用蒙特利尔认知评估量表筛查认知障碍,使用医院焦虑和抑郁量表筛查抑郁,使用Barthels指数评估日常生活活动。结果:150例患者中男性占56%,女性占44%,其中男性占36.67%,女性占32.67%。大多数患者为高血压和无业。在认知障碍方面没有观察到显著的社会人口学关联。与无认知障碍的患者相比,有认知障碍的患者在进食、洗澡和活动方面需要帮助。结论:本研究显示患者存在认知障碍,且与日常生活活动有关。抑郁症状和焦虑的存在也影响着非卧床血液透析患者的日常生活活动困难。患者尤其需要帮助爬楼梯和移动时的轻微帮助,偶尔的膀胱帮助,进食时的轻微帮助和行走时的轻微帮助。关键词:认知障碍,终末期肾病,透析,日常生活活动
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Association between Functional Status of Patients and Cognitive Impairment in End Stage Renal Disease
ABSTRACT Objective: The increased incidence of diabetes, hypertension in third world countries has lead to an increase in end stage renal disease which in turn escalates the burden of dialysis on patients and caregivers. Dialysis is associated with many serious physical and mental disturbances. The aim of this study is to highlight the importance of screening for cognitive impairment and depression in End stage renal disease because cognitive impairment can impair the activities of daily living and overall quality of life.   Methods: 150 patients were included in a study after fulfilling the inclusion and exclusion criteria. They were screened for cognitive impairment by using the Montreal cognitive assessment scale, for depression by using Hospital Anxiety and Depression scale and Barthels index for assessment of activities of daily living.  Results: Of 150 patients most were males (56%) and females were (44%) out of which 36.67% males and 32.67% of females were cognitively impaired. Most patients were hypertensive and unemployed.  There was no significant social demographic association observed for cognitive impairment. The patients with cognitive impairment need assistance in feeding, bathing and mobility as compared to patients with no cognitive impairment.   Conclusion: Our study revealed that cognitive impairment is present in patients and it is related with activities of daily living. The presence of depressive symptoms and anxiety is also affecting activities of daily living difficulty in ambulatory hemodialysis patients. Patients especially need help in climbing stairs and minor help in transferring, occasional bladder help, minor help in feeding and minor help during walk.  Key words: Cognitive impairment, End stage renal disease, Dialysis, Activities of daily living.  
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