女性痴呆患者における調理活動の治療的効果の検討

Therapeutic effect of cooking activity in female patients with dementia

要旨：記銘・記憶障害をもつ痴呆患者でも，長期間経験した生活関連技能は比較的良好に維持されている．今回，アルツハイマー型痴呆の女性患者14名に調理活動を実施し，知的精神面，日常生活，調理場面の3つの側面から評価を行った．調理活動の結果，知的精神機能の改善はみられなかったが，自発性や関心・意欲の向上など情緒面での改善が得られ，日常生活の行動面で変化がみられた．調理活動では，熟練した運動技能と認知的操作の経験から過去の作業イメージを再構築し，意識レベルに現実的作業体験をフィードバックするものと思われる．作業イメージの想起は，主婦としての社会的背景をもつ対象者の自己評価を強化し，役割感，有能感に代表される「自己実現」の感覚を成立させたものと考えられる．

　Life-associated skills performed over a long period are maintained relatively well even in patients with dementia accompained by encoding and memory disorder. In this study, we examined cooking as a therapeutic activity in 14 female patients with Alzheimer's dementia, and evaluated their intellectual capacity, daily living skills and the usefulness of therapeutic cooking activities. After therapeutic cooking activities were initiated, there was no improvement in intellectual capacity. However, there were emotional improvements including initiative and enhanced interest or volition. Behavioral changes in daily living were noted. During cooking activity, patients may have re-established a previous working image based on skilled exercise capacity and the experience of cognitive operation, feeding a realistic working experience back to the consciousness level. Retrieval of a working image may have intensified self-assessment in subjects with a social background as housewifes, establishing the sense of "self-actualization" represented by role concepts and feelings of ability.