Eye movement, cognition of group home physical environment, and risk of falling in elderly persons with dementia of Alzheimer's type

本研究的目的是同时测量阿尔茨海默型痴呆老年人日常生活中无限制条件下的眼动和行走，以验证他们的运动功能水平和对群体家庭物理环境或受试者生活环境的认知对跌倒和可能发生骨折的风险的影响程度。研究对象为102名居住在社区的阿尔茨海默型痴呆老人。调查是从涉及坠落风险的个人因素和环境因素的角度进行的。从多个Logistic回归模型中发现，既往跌倒与有无静止性脑梗塞、脑室周围白质病变、意识到沿途行走障碍的额外时间、注意到这些障碍的延迟以及行走时的不稳定有显著关系。接下来，对居住在3个不同物理环境的团体家庭中的20名阿尔茨海默型轻度痴呆患者进行了跟踪调查。结果表明，在有安全意识的群体家庭中，连续行走和变换不同姿势时的移动都非常稳定。此外，在布局良好、有良好环境刺激的集体住宅中，关于空间的视觉注意力转移是可以预测的，而且往往执行得很顺利。基于上述结果，有人建议，在团体之家环境中，安排一个可识别、安全和具有良好生活质量的环境对于照顾阿尔茨海默氏型痴呆症老人非常重要。

The aim of the present study is to measure simultaneously both eye movement and walking in the unrestricted condition in the daily life of elderly persons with dementia of Alzheimer's type, and to verify the degree to which their level of motor function and cognition of the group home physical environment or the subjects' living environment Influence the risk of falling and sustaining a possible fracture. The subjects of the study were 102 elderly persons with dementia of Alzheimer's type living in the community. The investigation was conducted from the standpoint of Individual factors Involved In the risk of falling and environmental factors. From using multiple logistical regression models, past falls were found to have a significant relation with the present/absent of silent infarctions, periventricular white matter lesions, the extra time the subject took to be aware of obstacles to walking along the way, lateness in taking note of them, and instability when walking. Next, a follow-up survey was conducted on 20 subjects with mild dementia of Alzheimer's type liying in 3 group homes, each with a different physical environment. The results showed that in safety-minded group homes continuous walking and moving when changing to different posture were very stable. Also, in well-laid out group homes with favorable environment stimuli, visual attention shifts with regard to space were predictable and tended to be performed smoothly. On the basis of the above mentioned results, It was suggested that an environment arranged so that things will be recognizable, safe and with good quality of life Is very important for the care of the elderly with dementia of Alzheimer's type in a group home setting.