Departmental Bulletin Paper 地域在住の二次予防プログラム参加者における運動機能と認知機能の変化

西田, 隆宏  ,  川崎, 涼子  ,  西原, 三佳  ,  本田, 純久

28pp.77 - 84 , 2016-01 , 長崎大学大学院医歯薬学総合研究科保健学専攻
【目的】二次予防事業の「運動器機能向上」「認知機能低下予防」の複合プログラムの効果を,基本チェックリストによる主観的評価と運動機能および認知機能測定値による客観的評価の両面から検証することを目的とした. 【方法】2014年4月から2015年 3月の1年間に二次予防事業に参加した佐世保市A地域在住の高齢者113人を対象とした.プログラムは3ヵ月間(12回)を1クールとし,週に1回2時間行われた.プログラム内容は筋力トレーニング,ストレッチ,脳トレーニングなどであった.この複合プログラム前後に,基本チェックリストの記入,主観的健康感の聴取,体力測定,認知機能測定を実施し,前後の比較を行った. 【結果】基本チェックリストの運動器の機能,認知症の症状,うつ症状および主観的健康感が有意に改善した.測定値では,5回椅子立ち上がりテスト,Timed Up and Go test,Mini-Mental State Examinationが有意に改善した. 【結論】「運動器機能向上」「認知機能低下予防」の複合プログラムを行うことで,運動機能,認知機能の向上が主観的評価値および客観的測定値によって認められた.
Locomotive syndrome and mild cognitive impairment are leading causes of the need for care, so early detection and treatments are central to care prevention for the frail elderly. The purpose of this study was to assess physical and cognitive function from the perspective of both subjective evaluation and objective measurements in a care-prevention program. Participants included 113 individuals (98 women, 15 men) ≥65 years old living in Sasebo city, who were at high risk for needing care according to screened using a basic checklist. The intervention, which combined a program to improve physical function and a program to prevent declines in cognitive function, was conducted once a week for 12 weeks from April 2014 to March 2015. Assessments using the basic checklist, self-rated health, physical fitness tests, and cognitive examinations were made at baseline and after completing the intervention, and results were then compared. Our results revealed that status of motor function, status of dementia risk and status of depression risk in the basic checklist were significantly improved compared to baseline (p<0.001, p=0.041, p=0.003, respectively), as was status of self-rated health (p<0.001). In terms of objective evaluation, results of the five-repetition sit-to-stand test and timed up-and-go test as physical fitness tests were significantly improved after the intervention (p<0.001 each), as was Mini-Mental State Examination score as a cognitive examination (p=0.005). Interventions combining programs to improve physical function and prevent declines in cognitive function thus appear useful to improve physical and cognitive functions in the frail elderly, using basic checklist assessments and objective measurements.

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