メモリーノートの活用が可能な記憶障害患者の認知機能の検討―当院の高次脳機能障害クリニカルパスの適用基準の検討から─

Cognitive functions in memory deficit patients who can use memory notes: A review of criteria for a clinical pathway for higher cortical dysfunctions in Aizawa Hospital

要旨：記憶障害患者のメモリーノートの使用の習得に求められる認知機能を明らかにすることを目的とした．当院で2009年9月～2011年1月まで高次脳機能障害クリニカルパスを適用し，メモリーノートの使用を習得したアウトカム達成群12名（男性9名，女性3名，平均年齢46.1±23.3歳）とアウトカム非達成群5名（男性4名，女性1名，平均年齢52.6±19.4歳）の認知機能検査のスコアを比較した．結果，Mann-WhitneyのU検定（p＝0.05）において，MMSE（場所の見当識，遅延再生）・日本版RBMT（約束）・K-WCST（第1施行CA）で有意差を認め，メモリーノートの使用の習得には作動記憶・遂行機能・展望記憶が重要であることが示唆された．

　The purpose of this study was to identify the specific cognitive functions required for learning to use memory notes in patients with memory deficits. The subjects were patients with memory deficits who applied the clinical pathway for higher cortical dysfunctions from September, 2009 to January, 2011 in Aizawa Hospital. The patients were divided into two groups: a favorable-outcome group (n＝12; male: 9, female: 3, average age: 46.1±23.3) and a non-favorable-outcome group (n＝5; male: 4, female: 1, average age: 52.6±19.4). The cognitive functional test scores of those two groups were compared. Using the Mann-Whitney U-Test, the results showed statistically significant differences between the 2 groups in MMSE (Mini Mental State Examination), RBMT (Rivermead Behavioral Memory Test), and K-WCST (Keio version Wisconsin Card Sorting Test). The results suggest that it is important for patients to have working memory, executive function, and prospective memory to effectively learn usage of memory notes.