Department of Memory Clinic, Kyoto Miniren Asukai Hospital, Kyoto, Japan.
Department of Memory Clinic, Biwako-Yoikuin Hospital, Otsu, Japan.
Psychogeriatrics. 2020 Sep;20(5):620-624. doi: 10.1111/psyg.12558. Epub 2020 May 5.
Day services (DS) are part of the public nursing care system in Japan. The purpose of DS is to help elderly individuals maintain mental and physical functions, eliminate feelings of isolation among homebound users, and reduce the burden of care on family members. However, the relationship between DS and the progression of Alzheimer's disease (AD) remains unclear.
We retrospectively analyzed 161 AD patients based on available Mini-Mental State Examination (MMSE) scores. The patients were divided into two groups: those who started to use DS (n = 106) and those who did not use DS (n = 55). We then compared the groups' MMSE scores between the first memory clinic visit and the 6-month point.
There were no significant differences between the two groups with regard to sex and the number of family members, but the non-DS group was younger, had more education, and had better MMSE scores at the first visit. At 6 months, we found a significant improvement in the MMSE scores of DS users, reflecting improved cognitive function. In addition, lower MMSE score at the first visit was associated with greater improvement in MMSE score at 6 months. Interestingly, the frequency of DS use had no significant effect on MMSE score. However, after approximately 6 months, DS use significantly improved the cognitive function of AD patients.
DS use significantly improved the cognitive function of AD patients. However, most DS users in Japan are older and have severe dementia. Patients who are younger, have more education, or have mild dementia dislike using DS. As a significant difference was found in the MMSE scores between the two groups after 6 months, DS use appears to be a useful non-drug therapy.
日托服务(DS)是日本公共护理系统的一部分。DS 的目的是帮助老年人保持身心功能,消除居家使用者的孤立感,并减轻家庭成员的照顾负担。然而,DS 与阿尔茨海默病(AD)的进展之间的关系尚不清楚。
我们根据现有的简易精神状态检查(MMSE)评分,对 161 例 AD 患者进行了回顾性分析。将患者分为两组:开始使用 DS 的患者(n=106)和未使用 DS 的患者(n=55)。然后比较两组患者在第一次记忆诊所就诊时和 6 个月时的 MMSE 评分。
两组在性别和家庭成员数量方面无显著差异,但非 DS 组年龄较小,受教育程度较高,首次就诊时 MMSE 评分较好。6 个月时,我们发现 DS 使用者的 MMSE 评分有显著改善,反映出认知功能的改善。此外,首次就诊时 MMSE 评分较低与 6 个月时 MMSE 评分的改善程度较大相关。有趣的是,DS 使用频率对 MMSE 评分无显著影响。然而,大约 6 个月后,DS 使用显著改善了 AD 患者的认知功能。
DS 使用显著改善了 AD 患者的认知功能。然而,日本的大多数 DS 用户年龄较大,且患有严重痴呆症。年龄较小、受教育程度较高或患有轻度痴呆症的患者不喜欢使用 DS。由于两组患者在 6 个月后 MMSE 评分存在显著差异,因此 DS 使用似乎是一种有用的非药物治疗方法。