地域在住高齢者の認知症発症と心理・社会的側面との関連

Psychosocial factors as predictors for dementia among community-dwelling older people

要旨：本研究の目的は，作業療法による認知症予防の手がかりを得ることである．対象は，65歳以上の地域在住高齢者で5年後にも要介護状態になかった健康寿命保持群2,110名と認知症で要介護状態となった230名である．5年間認知症にならずに健康寿命を保持している状態を予測するオッズ比を求めた．その結果，例えば趣味「あり」(オッズ比：2.27)，主観的健康感「よい」(2.00)，うつ「なし」(1.91)，IADL「自立」(2.56)などが，健診「受診」(1.71)，歩行「30分以上」(1.54)のオッズ比よりも大きかった．健康行動よりも，心理・社会面の望ましい状態を保持することが認知症予防には重要である可能性が示された．

　The Purpose of this study was to look for a method for preventing dementia through occupational therapy interventions.

　The subjects for this study included 2,340 elders of the community aged 65 years or over who were independent and active in their daily lives. They were followed for 5 years to catalogue incidences of dementia from 2000 to 2005.

　At the end of the follow-up period, the results gathered showed, of those who were independent and active, that 230 subjects had developed symptoms of dementia.

　Logistic regression analyses found that odds ratios (OR) for maintaining intellectual function included: having a hobby (OR: 2.27), having good self-rated health (OR: 2.00), not being depressed (OR: 1.91), receiving a medical check-up (OR : 1.71), and walking (OR : 1.54).

　It is suggested that maintaining a good psychosocial profile rather than focusing upon health behavior was key for preventing dementia.