認知症を有する高齢大腿骨近位部骨折患者のADLに関する研究―～重症度・精神症状に着目して～

Proximal femoral fracture in elderly patients with dementia and associated ADL: Focusing on severity and psychiatric symptoms

要旨：本研究の目的は，認知症を有する高齢大腿骨近位部骨折患者のADL能力改善が認知症の重症度と精神症状によってどのように異なるのか検討することである．対象者22名に対し，NMスケールにて認知症の重症度と精神症状，FIMにて入院時と退院時のADLを評価し比較した結果，重症度が高いほどADL能力の改善が難しかった．また，精神症状は重症度によって程度や内容が異なり，重症度が高いほどより精神症状が強く現れ訓練を阻害していた．重症度や精神症状がADL予後に影響を与える可能性が示唆された．今後は重症度と精神症状以外にもADL予後を左右する因子があると考えられるため様々な点から対象者を分析することが大切であると考える．

　The purpose of this research is to investigate how the improved ADL show the differences in the level of severity and the mental conditions of elderly dementia patients with proximal fracture. NM scale was used among 22 patients to examine the severity of their dementia and mental condition. FIM was also used to examine and compare ADL in the hospital and at discharge. The results indicate the greater the patients' severity, the less improvement there was in ADL. Each level of severity brought different degrees and details to the patients' mental conditions. The higher levels of severity led to an increased deterioration in their mental condition, which hindered their therapy. Consequently, levels of severity and mental conditions may influence ADL. The future may bring other factors that affect the ADL prognosis besides the severity of dementia and mental condition. Thus, it is important to analyze patients from various viewpoints.