Functional Performance of Alzheimer's Disease and Vascular Dementia in Southern Taiwan

南台灣社區阿滋海默氏症與血管性失智症患者生活功能之表現

蕭美玉(Mei-Yuh Shiau) ； 余麗樺(Li-Fa Yu) ； 阮慧沁(Hui-Shin Yuan) ； 林昭宏(Jau-Hong Lin) ； 劉景寬(Ching-Kuan Liu)

《The Kaohsiung Journal of Medical Sciences》 22卷9期 (2006/09) Pp. 437-446

摘要

This study investigated the functional performance of two major subtypes of dementia, Alzheimer's disease (AD) and vascular dementia (VaD), by the Functional Independence Measure (FIM), and to understand the need for assistance in performing activities of daily living. The subjects comprised 64AD and 21VaD patients who were recruited from two epidemiologic studies of dementia with a total of 3,931 community residents aged 65 years and above in southern Taiwan. The results showed that the severity of dementia was similar between the two groups. The mean score for AD was 82.7 and for VaD was 56.5 for total FIM (p＜0.05), 61.6 and 41.7 for the motor dimension (p＜0.05), and 21.1 and 15.7 for the cognitive dimension (p＜0.05). There were significant differences (p＜0.01) between AD and VaD in six FIM items and borderline or marginal significance (p＜0.05) in most of the FIM items. For AD patients, stairs, lower dressing, bathing, and tub/shower transfer were the most difficult items in the motor dimension, and it was memory in the cognitive dimension. For VaD patients, bathing, upper and lower dressing, and grooming were the most difficult items in the motor dimension, and it was problem solving in the cognitive dimension. VaD patients were more dependent on all FIM items and required more assistance than AD patients. The functional performances of dementia patients were significantly associated with dementia severity and subtypes, together accounting for 40% of the variability in total FIM. In conclusion, most dementia patients are dependent in daily activities and different types and severity of dementia lead to different disability profiles; individualized care is, therefore, most appropriate.

關鍵字

阿滋海默氏症 ； 生活功能獨立程度量表 ； 血管性失智症

並列摘要

This study investigated the functional performance of two major subtypes of dementia, Alzheimer's disease (AD) and vascular dementia (VaD), by the Functional Independence Measure (FIM), and to understand the need for assistance in performing activities of daily living. The subjects comprised 64AD and 21VaD patients who were recruited from two epidemiologic studies of dementia with a total of 3,931 community residents aged 65 years and above in southern Taiwan. The results showed that the severity of dementia was similar between the two groups. The mean score for AD was 82.7 and for VaD was 56.5 for total FIM (p＜0.05), 61.6 and 41.7 for the motor dimension (p＜0.05), and 21.1 and 15.7 for the cognitive dimension (p＜0.05). There were significant differences (p＜0.01) between AD and VaD in six FIM items and borderline or marginal significance (p＜0.05) in most of the FIM items. For AD patients, stairs, lower dressing, bathing, and tub/shower transfer were the most difficult items in the motor dimension, and it was memory in the cognitive dimension. For VaD patients, bathing, upper and lower dressing, and grooming were the most difficult items in the motor dimension, and it was problem solving in the cognitive dimension. VaD patients were more dependent on all FIM items and required more assistance than AD patients. The functional performances of dementia patients were significantly associated with dementia severity and subtypes, together accounting for 40% of the variability in total FIM. In conclusion, most dementia patients are dependent in daily activities and different types and severity of dementia lead to different disability profiles; individualized care is, therefore, most appropriate.

並列關鍵字

Alzheimer's disease ； Functional Independence Measure ； vascular dementia