アルツハイマー病患者の食事中に見られる動作・行為特徴—認知機能との関連による検討

Actions and behaviors found in clients with Alzheimer's disease while feeding : Investigation into cognitive relevance

要旨：アルツハイマー病（以下，AD）患者の食事遂行の質的特性を明らかにするために，対象者8名の食事遂行をビデオ録画して動作行為特徴を分析した．その結果，動作レベルの問題や行為全体としての崩れなど様々な特性が明らかになったが，対象者個々人の傾向は，①動作開始の困難と動作の停止を主特徴とする場合，②左右の手の非統合を主特徴とする場合，③マナーにそぐわない行為を主特徴とする場合など，いくつかに類別されることが示唆された．一部は，すでに他の神経疾患の行為特徴として記述されているものに類似していた．今回明らかとなった特徴は，今後AD患者の食事指導の個別化や精緻化をはかる際の重要な手がかりになると思われた．

　The purpose of this study is to describe the characteristics of action and behavior in eight patients with Alzheimer's disease while feeding themselves, and to investigate relationships between their characteristics and cognition. Subjects were videotaped while having a meal, and their action and behavior were analyzed through qualitative analysis. Their characteristics were classified and divided into sixteen categories, revealing that eight patients have various characteristics on problem of action and breakdown of behavior. The chief tendency of these eight patients could be divided into three types : making a stop of action, problem of space coordination, and against social rules of behavior. And some of the sixteen categories are similar to apraxic syndromes found in the brain injured, and to characteristics of fronto-temporal dementia, and Parkinson's disease. These characteristics could help the care of feeding and rehabilitation for each patient with Alzheimer's disease by corresponding to each patient's characteristics of action and behavior.