認知症の非薬物療法—ケア，BPSDの対応を含めて

Non-pharmacological Interventions to Treat Clinical Symptoms in Patients with Dementia

これまでのメタ解析によって，認知機能障害に対する認知刺激療法，日常生活動作に対する運動療法，行動・心理症状（BPSD）に対する音楽療法と行動マネジメントの有効性が確認されている。行動マネジメントのエッセンスはケアを行う人たちに広く知ってもらうことが重要で，そのような活動がわが国でも行われている。また非薬物療法を認知症患者の普段の生活の中に取り入れ，BPSDを予防するという観点も重要である。

Abstract

Previous systematic reviews of non-pharmacological interventions for clinical symptoms in dementia patients have confirmed the effectiveness of cognitive stimulation therapy (CST) for cognitive impairment, exercise therapy for activities of daily living, and music therapy and behavior management techniques for behavioral and psychological symptoms of dementia (BPSD). A Japanese version of CST has been developed and is available, but standardized exercise therapy and music therapy have not been developed. It is also important for informal and formal caregivers to learn behavior management techniques. Thus, attempts are being made to promote the use of behavior management techniques in Japan. It is further important to incorporate non-pharmacological interventions into the daily life of dementia patients and to prevent the development of BPSD. In Japan, these interventions are usually provided in care services for elderly people and are covered by the Japanese long-term insurance system. Thus, it is advisable for dementia patients to start using these care services before they develop BPSD. The effectiveness of non-pharmacological interventions in patients with diseases causing dementia other than Alzheimer's disease has not yet been assessed.