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Intervention study of Day Care Rehabilitation

日托康复干预研究

基本信息

批准号：
07407069
负责人：
SHIDO Koichi
金额：
$ 1.86万
依托单位：
Hokkaido University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07407069/
关键词：
Day Care Rehabilitation Life expectancy Senile dementia of Alzheimer type Vascular dementia Quality of life アルツハイマー病血管性痴呆脳活性訓練痴呆化阻止多変量解析ケアマネージメント

项目摘要

In the treatment of senile dementia, Rehabilitation rather than drugs, could result in more positive long-term effects. A Day Care program designed for individuals with Senile Dementia of Alzheimer type (SDAT) and Vascular Dementia (VD : MID and BD), activates the brain through memory training, creative arts therapy, and social interaction. The objcctive of this study is to determine if Day Care can modify the patients intellectutal decline or even alter the natural course of the dementing illness.135 SDAT and 213 VD patients were studied over three years. ADL (Activities of Daily Living) measurements were evaluated by the Barthel Index and cognitive measurements by the NM-scale. The Wilcoxon test and the Sign test were carried out using the BI and NM-scale scores. These results indicate a decline or arrest in the progression of SDAT and VD as determined by the multiple logistic models. The 8 variables (risk factors, medication, age at onset, self-rehabilitation, family support, sex, grade of dementia and Day Care) influence on the survival curves was calculated using the Kaplan-Meire Life table method. The Cox proportional hazard analysis was then used to examine the relationship between the 8 variables and dementia.The significantly positive results from these four analyzes od ADL and cognitive measurments indicate that Day Care programs clearly retards the progression of intellectual decline in dementia patients and improves the quality of life (QOL) in all cases. In VD patients the mortality rate was notably decreased through Day Care. These results make one consider the benefits of introducing such programs into severe, rehabilitating dementia. However a healthy diet, a physically and mentally active Life, as well as ear1y diagnosis, are the best preventions against dementia.

在老年性痴呆的治疗中，康复治疗比药物治疗更能取得积极的远期疗效。为阿尔茨海默型老年痴呆症（SDAT）和血管性痴呆症（VD：MID和BD）患者设计的日托计划，通过记忆训练，创造性艺术治疗和社交互动激活大脑。本研究的目的是确定日托是否可以修改病人的智力下降，甚至改变痴呆症的自然病程。135 SDAT和213 VD患者进行了为期三年的研究。ADL（日常生活活动能力）测量通过Barthel指数和认知测量通过NM量表进行评估。使用BI和NM量表评分进行Wilcoxon检验和符号检验。这些结果表明SDAT和VD的进展下降或停滞，如由多个逻辑模型确定的。采用Kaplan-Meire寿命表法计算8个变量（危险因素、药物、发病年龄、自我康复、家庭支持、性别、痴呆程度和日托）对生存曲线的影响。考克斯比例风险分析结果显示，这四项分析的ADL和认知测量结果均为显著正相关，表明日托计划明显延缓了痴呆患者智力衰退的进展，并改善了所有病例的生活质量。在VD患者中，通过日托，死亡率显著降低。这些结果使人们考虑将这些计划引入严重的康复性痴呆症的好处。然而，健康的饮食，积极的身心生活，以及早期诊断，是预防痴呆症的最佳方法。