精神科デイ・ケアにおけるフレイル予防プログラムの身体機能・精神症状・生活遂行度への影響—非ランダム化比較試験による予備的検討

Effects of a frailty prevention program in psychiatric daycare on physical function, psychiatric symptoms, and performance of daily living: A preliminary non-randomized controlled trial

要旨：近年，精神科領域では健康寿命の延伸が注目されている．健康寿命の延伸には，フレイル予防が導入されている．そこで，本研究は精神科デイケアの利用者を対象にフレイル予防プログラムを実施し，参加しなかった利用者と比較して心身機能や日常生活に対する改善効果に違いがあるのか検討した．プログラムは3ヵ月間12回とし，高齢者に対するフレイル予防を参考に立案し非ランダム化比較試験を実施した．分析対象者37名の平均年齢は50.5歳で，プログラム群（25名）は非参加群（12名）よりも身体機能や生活遂行度，精神症状に有意な改善がみられた．本研究より，精神科デイケアでも年齢に関係なくフレイル予防の必要性が示唆された．

　In recent years, premature deaths and low levels of physical activity among people with mental illnesses have become an issue. This study examined the effects of a physical activity program in addition to a regular program (experimental group) on physical, psychological, and life satisfaction outcomes compared to a control group in a regular program at a psychiatric daycare setting. The study design was an intervention study using a non-randomized group comparison test. Twenty-five participants in the experimental group and 12 participants in the control group were included in the analysis. Both groups had a lower level of physical functioning compared to healthy older adults, and more than half of the participants were at risk for obesity, polypharmacy, and frailty. The results of the split-plot analysis of variance showed an interaction effect on “grip strength,” “Five times sit-to-stand test,” “maximum walking speed,” “Short Physical Performance Battery,” “Brief Psychiatric Rating Scale,” and “life performance” in the experimental group compared to the control group. This study indicates that physical activity programs in psychiatric daycare may have effects on physical and psychological aspects.