- 期刊
比較輕微阿茲海默症及血管性失智症老年患者同時之動作表現
Comparison of Motor Performance between Elderly Patients with Mild Alzheimer and Vascular Dementia in Motion Analysis
摘要
根據過去研究指出造成失智症患者在動作及步態上較同年齡的健康人有較差的表現，主要是由於患者在腦部的退化及受損。然而不同型態之失智症患者其腦部受損區域不同也會造成不同型態的患者在動作表現也會有所不同。本研究目的是以動作分析爲早期失智症最常見兩大原因，阿茲海默及輕微血管型失智症患者在同時動作執行(dual task)的表現差異作探討，將所徵召的受測者分爲3個族群：(1)健康老人組，(2)輕微阿茲海默患者(Alzheimer's disease)，(3)輕微血管型失智症(vascular dementia)，每組共收取10位受測者。本研究將利用動作分析系統來計算出受測者在不同狀態下步態參數及自製電路板來運算出上肢動作表現參數。在測試過程中包含下列三種型態：(1)自然動作反應(2)自然動作反應同時執行認知任務：此任務爲念予2位阿拉伯數字請受測者倒念一次(3)自然動作反應同時執行記憶任務:此任務爲念予2位阿拉伯數字請受測者重複一次。結果顯示兩組失智症患者在動作表現上均較同年齡的健康人有較差的表現，特別是在同時任務執行時，阿茲海默症患者未達統計學上顯著差異，而血管性失智症患者會較於同年齡的健康人有顯著差別。而在同時任務執行介入後又以上肢動作表現明顯較下肢動作表現更容易受到影響。
並列摘要
In the past research, most factors caused motor and gait impairment in patients with dementia were related to the lesions of different areas and lobes. However, patients with different types of dementia may have distinct motor impairment features because of different neuropsychological dysfunction that may result in different motor features. At present time, clinical diagnosis of dementia patients were depended on subjective rating scales, but lack of objective measurement. The purpose of this study was to compare the patients with mild Alzheimer's dementia (AD) and patients with mild vascular dementia (VaD) in motion analysis of gait and upper limbs function in older to find out the clinical application of early diagnosis for early dementia. Method: The subjects were recruited into three groups: (1) healthy elderly, (2) mild possible Alzheimer's disease, (3) mild possible vascular dementia. They were diagnosed by Clinical Dementia Rating Scale (CDR) for the severity of dementia. In this study, motion analysis was used to evaluate the kinematics' parameters to compare gait performance and upper limbs function was measured by a new designed computer board. There were three types of motor task evaluated: (1) sequence, (2) sequence task combined with dual-task by reverse 2 digits, (3) sequence task combined with dual task by memory 2 digits. The result revealed the patients with mild dementia in both groups had poor motor function than age-matched healthy subjects. In dual task condition, the vascular dementia group showed worse motor performance than age-matched healthy subjects and there were more significant difference in the upper limbs motion than in the gait motion.