認知功能損傷患者的認知能力與日常生活功能之相關性

Relationship between Cognitive Ability and Activities of Daily Living in Patients with Cognitive Impairment

徐宛伶(Wan-Ling Hsu) ； 騫心曼(Hsin-Man Chien) ； 廖梓葳(Tzu-Wei Liao) ； 盧奕均(Yi-Chun Lu) ； 曾奕翔(I-Shiang Tzeng)

《北市醫學雜誌》 預刊文章 Pp. 1-14

https://doi.org/10.6200/TCMJ.202101/PP.0025

摘要

目的：中風（stroke）、創傷性腦損傷（traumatic brain injury, TBI）與後天性腦損傷患者除有動作損傷外，也常有特定的認知障礙。本研究目的為探討認知問題與其日常生活功能（activities of daily living, ADL）之相關性，包含基本日常生活功能（basic activities of daily living, BADL）與工具性日常生活功能（instrumental activities of daily living, IADL）。方法：本研究共收取13位認知損傷個案（平均年齡61.64.±14.43歲），使用簡短智能測驗（Mini Mental State Exam, MMSE）、中文版蒙特利爾智能測驗（Montreal Cognitive Assessment, MoCA）、知能篩檢測驗（Cognitive Abilities Screening Instrument, CASI C-2.0）、魏氏成人智力量表第四版－記憶廣度分測驗（Digit Span subtest, DS）、路徑描繪測驗（Trail Making Test part A, TMT-A）、顏色路徑描繪測驗（Color Trail Making Test, CTT）、功能獨立量表（Functional Independence Measure, FIM）與工具性日常生活活動能力量表（IADLs）等來量測個案的認知功能與日常生活功能；並使用斯皮爾曼等級相關係數（Spearman's rank correlation coefficient）來了解認知損傷與ADL間的相關性。結果：結果顯示MMSE、MoCA、CASI C-2.0皆與BADL/IADL有顯著正相關存在（P＜0.05），認知表現越佳其ADL表現越獨立。TMT-A及CTT也與部分BADL/IADL分項及總分有顯著負相關，表示執行功能越差時ADL能力也越不佳，尤其是複雜的IADL的活動。結論：認知問題與日常生活功能表現具有相關性存在，當認知表現越不佳，ADL表現亦會受到影響。影響BADL/IADL的認知層級與因子可能會有差異存在，仍需未來研究進一步了解。

關鍵字

認知損傷 ； 基本日常生活功能 ； 工具性日常生活功能 ； 相關性

並列摘要

Objective: Patients with stroke, traumatic brain injury, or acquired brain injury have specific cognitive impairment besides motion problems. This study attempted to investigate the correlation between cognitive problems and daily living functions in patients with cognitive impairment, including the basic activities of daily living (BADL) and instrumental activities of daily living (IADL). Methods: A total of 13 patients with cognitive impairment were included in the study (mean age = 61.64±14.43 years). Cognitive impairment and daily living functions were assessed using the Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Cognitive Abilities Screening Instrument (CASI C-2.0), Digit Span subtest (DS), Trail Making Test part A (TMT-A), Color Trail Making Test (CTT), Functional Independence Measure (FIM), and Instrumental Activities of Daily Living scale (IADLs). The Spearman's rank correlation coefficient was used to examine the correlation between cognitive impairment and ADL. Results: Positive correlations were found between the global cognitive functional tests (MMSE, MoCA, and CASI C-2.0) and FIM/IADLs (p＜0.05). The patients with better cognitive function had better performance on daily life activities. Negative associations were noted between TMT-A/CTT and some sub-tests and total scores of FIM/IADL, implicating that executive function could affect the functional abilities, particularly the IADL. Conclusion: There is an association between cognitive problems and daily living functions in patients with cognitive impairment. ADL worsens when ADL is dissatisfied. Further study is needed because cognitive levels and factors affecting BADL and IADL may be different.

並列關鍵字

cognitive impairment ； basic activities of daily living ； instrumental activities of daily living ； correlation