認知症患者に対するコンピューターを用いた認知機能向上訓練の効果―前頭連合野機能を基盤とし個人の能力・興味にテーラーメイド可能な訓練の開発と試行から─

Effects of cognitive rehabilitation using computers on a dementia patient: Development and trial of a tailor-made training program based on prefrontal function

要旨：ワーキングメモリ機能，目的志向的行動の計画や実行など前頭連合野機能を基盤にし，個人の興味・関心や遂行能力にテーラーメイド可能な訓練を開発した．今回，アルツハイマー型認知症の1症例に施行したところ，語の流暢性，抑制コントロール，記憶機能に向上を認めた．また，日常生活面での記憶，見当識，会話に改善が得られ，うつ状態評価尺度や症例の感想から情動面の改善も示唆された．本訓練は実生活に密着した内容で，対象に合わせて課題の難易度や題材を設定できる．単なる反復的な記憶訓練ではなく過去の記憶やアイディアの創出を刺激することを意図している．こうした特徴が症例の認知・情動の両側面の機能改善に寄与したと考えられた．

　We developed a cognitive rehabilitation program based on the prefrontal cortex functions such as the working memory, planning and decision making. The program is adjustable according to each individual's interest and capability. The present study attempted to clarify the effect of this cognitive rehabilitation program by introducing appropriate tasks to a dementia patient. The results showed improvement in verbal fluency, inhibition control and verbal and spatial memory functions. In addition, the daily activities and emotional functions also improved. The contents of this training simulated our daily life activities for our past memories and ideas. The degree of difficulty is adjustable according to individual interest and capability. These results indicate that these characteristics contributed to the improvements of the patient's cognitive and emotional functions.