頁籤選單縮合
題名 | 老人主觀記憶力障礙與功能缺損有關--以社區醫院病人為對象的研究=The Positive Correlation between Subjective Memory Impairment and Functional Impairment among Elderly People: A Community Hospital-based Study |
---|---|
作者 | 林智偉; 劉文俊; 吳風鈴; 陳慶餘; Lin, Chih-wei; Liu, Wen-jing; Wu, Feng-ling; Chen, Ching-yu; |
期刊 | 臺灣老年醫學暨老年學雜誌 |
出版日期 | 20130200 |
卷期 | 8:1 2013.02[民102.02] |
頁次 | 頁14-27 |
分類號 | 415.8471 |
語文 | chi |
關鍵詞 | 主觀記憶力障礙; 失智症; 老人周全性評估; 功能缺損; Subjective memory impairment; Dementia; Comprehensive geriatric assessment; Functional impairment; |
中文摘要 | 目的:老年人抱怨有記憶力衰退是臨床上很常見的一種現象,雖然常不符 合失智症的診斷,但在臨床照護上是否代表是功能缺損的徵兆?本研究主旨在 了解主觀有記憶力障礙之老者,其在認知、生理、心理及日常生活功能等層面 是否已出現有意義之衰退。 方法:本研究乃收集2006年1月至2007年6月接受衛生署補助12家地區醫院 提供老年人整合性照護服務計畫之周全性評估之老人共1,031人,經排除符合 以下條件者後進行分析:(1)年齡<65歲者,(2)住院天數≤2天或>30天者,(3)未 完成出院一年後之追蹤者,(4)缺少記憶力障礙主觀資料者。 結果:共得有效樣本728人,其中主觀有記憶力障礙的老人380人(52.2%), 主觀無記憶力障礙的老人348人(47.8%),兩組在性別、教育程度、獨居狀態、 住院天數、跌倒狀況、多重用藥及疼痛等變項中無統計上的差別。但主觀有記 憶力障礙的老人,其死亡率較高(23.9% V.S. 13.8%),且有憂鬱症狀、溝通障礙、 行動障礙之比率顯著較高。功能評估分數方面,單變項分析時,主觀有記憶力 障礙的老人,簡易智能量表(MMSE)、老年憂鬱量表(GDS-15)、簡易營養評估 量表(MNA)、住院時日常生活功能量表(ADL)及工具性日常生活功能量表 (IADL)之得分皆顯著較差。另外,以教育程度校正MMSE界定分數,有記憶力 障礙的老人其MMSE界定為異常的比例較高。 結論:本研究顯示接受衛生署補助地區醫院提供老年人整合性照護服務計 畫之周全性評估之老人,主觀有記憶力障礙之比率相當高,約接近五成。主觀 有記憶力障礙者同時合併有老年功能缺損的比例高,功能評估得分較低,死亡 率較高等現象。顯示當老年人出現主觀記憶力障礙時,有需要積極評估醫療介 入的必要性。 |
英文摘要 | Objectives: Cases related to complaints about memory decline from elderly patients are fairly common in clinical settings, though most of the cases fail to meet the criteria of dementia. Our study aims to understand the correlation between subjective memory impairment (SMI) and functional impairment among elderly people.Method: The sample comprises 1031 hospitalized patients receiving comprehensive geriatric assessments (CGA) in 12 community hospitals between January 2006 and June 2007. Patients who were younger than 65 year old, hospitalized for less than 2 days or over 30 days, could not be reached during follow-ups in one year after discharge, or failed to complete the SMI information, were excluded.Results: A total of 728 patients were recruited. 52.2% of the individuals reported SMI. SMI was correlated with higher mortality rate. Individuals with SMI had higher rates in depression and problems with communication and ambulation. Single variable analysis also found them scoring lower in mini-mental state examination (MMSE), geriatric depression scale (GDS-15), mini-nutritional assessment (MNA), activities of daily living (ADL), and instrumental activities of daily living (IADL). Furthermore, more individuals with SMI were classified as having abnormal MMSE results after stratifying MMSE scores by education.Conclusions: SMI appeared to be prevalent in the elderly patients admitted to community hospitals. They had higher rates of functional decline, lower scores in functional assessments, and higher mortality rates. As indicated by the results, elderly patients complaining about memory impairment are in an urgent need of comprehensive evaluation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。