[[alternative]]The Effects of Thematic Physical Activity on Cognition, Happiness and Physical Fitness in Patients with Neurocognitive Disorders

[[abstract]] 背景及目的：依據台灣失智症協會及內政部資料的估算，在台灣65歲以上的老人約每12人就有1位失智者。失智症的意識清楚，但認知功能下降或缺損的病程不只發生在譫妄期間，超過90% 個案在失智症的病程中會出現精神行為症狀，增加了照顧者身體、心理、社會及經濟上的沉重負擔。在DSM-5中引進了「認知類障礙症」取代DSM-Ⅳ「失智症、譫妄、失憶症、和其他認知疾病」的說詞，將認知障礙範疇的診斷門檻降低，只需要有一種以上的認知障礙即認定，不但避免「失智症(癡呆症)」之汙名化，也有助於早期發現認知缺損個案盡早介入處遇，所以研究目的為主題式體能活動對認知類障礙患者認知、幸福感與體適能之成效探討。 材料及方法：採類實驗研究設計，以南部日照中心認知類障礙患者為收案對象，計收案52名。採方便取樣分配，實驗組30名，對照組22名，實驗組進行本研究之主題式體能活動介入方案，對照組則維持原日照中心之常規活動。兩組分別於4週、8週、12週進行認知、幸福感、體適能測量，以了解兩組的差異。 結果：研究結果發現在經過12週的主題式體能活動對認知類障礙患者在認知方面的定向感、社區活動能力、家庭活動與嗜好有顯著效益，在幸福感方面的心身健康和體適能亦均有顯著差異。 結論: 依照本研究結果建議於日照中心可採主題式體能活動增進認知類障礙患者認知、幸福感與體適能之成效，減少未來的健康醫療照護成本。[[abstract]] Background and Purpose：According to estimates from the Taiwan Dementia Association and the Ministry of the Interior, about 1 in 12 people over 65 years old has a dementia in Taiwan. The consciousness of dementia patients are clear, but the course of cognitive decline or impairment does not only occur during delirium. More than 90% of the cases will have psycho-behavioral symptoms during the course of dementia, which increases the physical, psychological, social and economic burden on the caregivers. In DSM-5, “neurocognitive disorder” was introduced to replace DSM-IV “Dementia, Delirium, Amnestic, and other Cognitive Disorder”, which lowered the threshold for the diagnosis of cognitive disorders. One or more than one of cognitive dysfunction would be recognized as neurocognitive disorder, which is not only avoiding the stigmatization of “dementia”, but also helping early detection and early treatment by intervening activities. The research aimed to understand the effects of thematic physical activity on cognition, happiness and physical fitness in patients with neurocognitive disorders. Materials and Methods：The study used a quasi-experimental design. Fifty-two demented cases in the Southern Day Care Centers were recruited by intentional sampling. The experimental group included thirty cases participating in the thematic physical activity. The control group included twenty-two cases participating in regular group activities. The differences between cognition, happiness, and physical fitness of two groups were evaluated after four weeks, eight weeks, and twelve weeks. Results：The results are as following: First, neurocognitive disorder cases have significant improvement including orientation, community activity ability, family activities and hobbies in cognition. Second, their physical and mental health in happiness improved. Third, their fitness are also increasing. Finally, we found cases executing thematic physical activities for twelve weeks have a significant and positive correlation. Conclusion：This study reflects thematic physical activities in the Day Care Centers can improve the effectiveness of cognition, happiness and physical fitness in neurocognitive disorder cases, and reduce following health care costs in the future