Altruistic Behavior in Dementia Patients experiencing a Reduction of Physical Performance : Relationship between Altruistic Behaviors and Symptoms of Dementia or Self-care Ability

本研究の目的は,身体活動能力の低下を伴う痴呆患者における愛他的行動の出現頻度や出現内容を観察するとともに,愛他的行動の出現が痴呆の重症度・症状類型やセルフケアの自立度と関連するかを明らかにすることである.一般総合病院で理学療法を受けている入院痴呆患者39名を対象に,1ヶ月間の愛他的行動の出現を観察し,また,改訂版長谷川式簡易知能評価スケール(以下HDS-R)と高齢者用多元観察尺度(以下MOSES)を用いて,痴呆の重症度と社会活動性を評価した.愛他的行動の出現頻度は1〜45回,1回も出現しなかった患者は2名であり,総数では605回の愛他的行動が観察された.愛他的行動の出現頻度は,HDS-Rとの間に相関関係を認めなかったが,MOSESの総点との間に有意な相関関係を認めた.愛他的行動の出現頻度に最も影響するMOSESの下位尺度は「引きこもり」と「イライラ感」であった.結果より,痴呆患者においても少なからず愛他的行動が残存し,それは引きこもりやイライラ感が少ない者で多く観察されることが示された.The purpose of this study was to observe the frequency of appearance and appearance situation of altruistic behavior in dementia patients experiencing a reduction of physical performance and to clarify if this frequency is related to the severity or type of dementia and the self-care ability of patients. Thirty nine in-patients undergoing physical therapy in a general hospital participated in this study. We observed the appearance of altruistic behavior in subjects, and used the revised Hasegawa dementia scale (HDS-R) and multidimensional observation scale for elderly subjects (MOSES) to evaluate the severity and social activity of subjects. The appearance of altruistic behavior was observed 1-45 times and having not appeared was two patients, and the total frequency was 605 times. The appearance frequency correlated with MOSES, but was unrelated to HDS-R. The MOSES subscale which influences most was "withdrawal" and "irritation". It was suggested that not a little altruistic behavior remained in patients and that this behavior was observed mostly in subjects who exhibited little withdrawal or irritation