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Taking Another Look: Thoughts on Behavioral Symptoms in Dementia and Their Measurement

机译：换个角度看：痴呆症的行为症状及其测量的思考

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This article proposes taking another look at behavioral symptoms of dementia (BSDs) both from a theoretical perspective that informs research and practice and from a measurement perspective. We discuss why this rethinking of behaviors impacts current models of care and our ability to better detect outcomes from interventions. We propose that BSDs be viewed from a pattern perspective and provide some suggestions for how to identify and measure these patterns that can influence the timing and type of intervention. Evidence suggests that BSDs are complex, sequential, patterned clusters of behavior recurring repeatedly in the same individual and escalate significantly without timely intervention. However, BSDs are frequently viewed as separate behaviors rather than patterns or clusters of behaviors, a view that affects current research questions as well as the choice, timing, and outcomes of interventions. These symptoms cause immense distress to persons with the disease and their caregivers, trigger hospitalizations and nursing home placement, and are associated with increased care costs. Despite their universality and that symptoms manifest across disease etiologies and stages, behaviors tend to be underrecognized, undertreated, and overmanaged by pharmacological treatments that may pose more harm than benefit.
机译：本文建议从有助于研究和实践的理论角度以及从测量角度来对痴呆症的行为症状进行另一种观察。我们讨论了为什么对行为的这种重新思考会影响当前的护理模式以及我们更好地从干预中发现结果的能力。我们建议从模式角度看待BSD，并为如何识别和测量可能影响干预时间和类型的模式提供一些建议。有证据表明，BSD是复杂的，连续的，有规律的行为簇，在同一个人中反复发生，并且在没有及时干预的情况下显着升级。但是，BSD通常被视为单独的行为，而不是行为的模式或集群，这种观点会影响当前的研究问题以及干预措施的选择，时机和结果。这些症状会给患有该疾病的人及其护理人员带来极大的痛苦，引发住院治疗和疗养院安置，并增加护理费用。尽管它们具有普遍性，并且症状在疾病的病因和阶段中均表现出来，但这些行为往往被药理学治疗所认识不到，治疗不足和管理过度，这可能带来弊大于利。

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