挖掘神经心理学评估在康复中的价值：来自痴呆症患者及其照顾者的观点。
Unlocking the Value of Neuropsychological Assessments in Rehabilitation: Perspectives from Persons with Dementia and Their Caregivers.
作者信息
Yoshimura Takako, Osawa Aiko, Maeshima Shiinchiro, Ueda Iikue, Kawamura Koki, Kamiya Masaki, Itoh Naoki, Arai Hidenori
机构信息
Department of Speech and Hearing Disorders and Sciences, Research Institute for Coexistence and Health Science, Kyoto University of Advanced Science, Kyoto, Japan.
Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
出版信息
Curr Ther Res Clin Exp. 2025 Mar 1;102:100781. doi: 10.1016/j.curtheres.2025.100781. eCollection 2025.
PURPOSE
Various neuropsychological or cognitive assessments are often conducted before rehabilitation to ascertain patients' function, disability, and environment. However, adequate assessments are not conducted for persons with dementia under the assumption that assessments would burden them. Therefore, this study investigated the perceptions of persons with dementia and their family caregivers regarding cognitive function assessments during hospital rehabilitation and reconsidered the significance of such assessments according to the opinions of those involved.
METHODS
This cross-sectional observational study was conducted over a 3-month period at a hospital-based rehabilitation center. We administered a semi-structured questionnaire to 31 older persons with dementia (13 men and 18 women; mean age [± SD]: 77 [± 5.7] (range: 66-87 years); mean years of education [± SD]: 12 [± 2.3]; (range: 9-16 years); Alzheimer's disease: 15; mild cognitive impairment (MCI): 15; corticobasal degeneration: 1) and 49 family caregiver dyads (24 men and 25 women, mean age [± SD]: 67 [± 11] years; age range: 46-90 years). The data were interpreted by employing descriptive statistics, and the χ, Fisher's exact, and Kruskal-Wallis tests.
FINDINGS
Both groups acknowledged the value of neuropsychological assessments, with 94% (95% CI 84.9-100%) of persons with MCI/dementia and 83% (95% CI 73.3-94.0%) of their family caregivers linking them directly to enhanced treatment and care quality. Their positive attitudes were significantly associated with the belief that such evaluations are integral for personalizing and optimizing rehabilitation strategies.
IMPLICATIONS
Most individuals with MCI/dementia and their caregivers value detailed neuropsychological assessments for understanding rehabilitation needs, highlighting the importance of integrating comprehensive evaluations into dementia care. However, the single-center nature of our study limits generalizability. Future research with diverse participants is needed to develop scalable, inclusive rehabilitation strategies.
目的
在康复治疗前，通常会进行各种神经心理学或认知评估，以确定患者的功能、残疾状况和环境。然而，由于认为评估会给痴呆症患者带来负担，因此并未对他们进行充分评估。因此，本研究调查了痴呆症患者及其家庭护理人员对医院康复期间认知功能评估的看法，并根据相关人员的意见重新审视了此类评估的意义。
方法
本横断面观察性研究在一家医院康复中心进行，为期3个月。我们对31名老年痴呆症患者（13名男性和18名女性；平均年龄[±标准差]：77[±5.7]岁（范围：66 - 87岁）；平均受教育年限[±标准差]：12[±2.3]年（范围：9 - 16年）；阿尔茨海默病：15例；轻度认知障碍（MCI）：15例；皮质基底节变性：1例）和49对家庭护理人员（24名男性和25名女性，平均年龄[±标准差]：67[±11]岁；年龄范围：46 - 90岁）进行了半结构化问卷调查。采用描述性统计、χ²检验、费舍尔精确检验和克鲁斯卡尔 - 沃利斯检验对数据进行解读。
结果
两组均认可神经心理学评估的价值，94%（95%置信区间84.9 - 100%）的MCI/痴呆症患者及其83%（95%置信区间73.3 - 94.0%）家庭护理人员认为这些评估与提高治疗和护理质量直接相关。他们的积极态度与认为此类评估对于个性化和优化康复策略不可或缺的信念显著相关。
启示
大多数MCI/痴呆症患者及其护理人员重视详细的神经心理学评估以了解康复需求，这凸显了将全面评估纳入痴呆症护理的重要性。然而，本研究的单中心性质限制了其普遍性。未来需要针对不同参与者开展研究，以制定可扩展、包容性强的康复策略。
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