最重度認知症におけるQOLとは : 感覚刺激療法を通して

近年,認知症を対象とした非薬物療法が盛んに実施されているが,運動機能が低下し,言語機能が崩壊し,意思疎通が困難となる最重度期の認知症に対しては,各種の非薬物療法の適応は難しくなる.今回,最重度認知症に対しての有効性が示唆される感覚刺激の効果を検討するため,介護老人福祉施設入所中の最重度認知症高齢者10名に複数の感覚刺激を与える介入実験を実施し,認知症用に開発されたQOL尺度を用いて感覚刺激の有効性を検討した.その結果,感覚刺激による有効性は認められなかったが,認知症の重症度とQOLについて有意な相関を認め,認知症の重症度が高いほど,陽性感情の表出あるいは表情の変化がQOLの要素として重要であることが示唆された.また,最重度認知症では,失われていく機能そのものがQOLの要素に反映されることが示され,最重度認知症においては,行動面に変化がなくても,発話や反応,表情の変化を示すことが重要な意味を持つと思われた.Non-pharmacological therapies have been widely used in the treatment of dementia in recent years, but the application of such therapies becomes difficult for the most serious cases involving impaired motor function, loss of speech function, and communication difficulties. In this study, we examined the effectiveness of sensory stimulation, which has been shown to be effective in the most serious cases of dementia. Specifically, we administered multiple sensory intervention examinations to 10 aged profoundly dementia patients, and measured the effectiveness of sensory stimulation using QOL benchmarks developed for dementia. The current study did not find that sensory stimulation was effective. However, a significant correlation was found between QOL and the seriousness of dementia, suggesting that the more serious a patient\u27s dementia, the more important the expression of positive feelings or changes in facial expression become as an important QOL factor. Additionally, the study has shown that, in severe dementia, lost functions themselves become reflected in QOL factors. Therefore, talking, reacting, and changes in facial expression appear to have significant meaning even if there are no external changes in the patient\u27s activities