輕－中度失語症個案認知能力之探討與分析

Exploration and Analysis of Cognitive Ability in Mild-to-Moderate Cases of Aphasia

施益湋(Yi-Wei Shih) ； 林佳蓉(Chia-Jung Lin) ； 何宏祥(Hung-Hsiang Ho)

《澄清醫護管理雜誌》 13卷1期 (2017/01) Pp. 8-14

摘要

目的　目前國內針對失語症個案的認知狀況與學習能力的研究較為缺乏，因失語症個案的評估有相當難度，如聽理解、閱讀障礙、表達困難⋯等因素干擾評估的正確性。本研究目的在探討輕-中度失語症個案的認知能力以及分析認知與語言障礙程度的關係，進而了解其學習的能力。期望研究結果可作為未來設計失語症個案治療計畫之參考依據。方法　本研究將受試者分為失語症組與正常健康組，兩組均接受MMSE與LOTCA-II評估，失語症組則需再接受CCAT評估，以瞭解其語言障礙嚴重度。探討（1）失語症組LOTCA-II各分項的表現；（2）失語症組與正常健康組LOTCA-II是否存在顯著差異；（3）失語症組LOTCA-II與CCAT的相關性。結果　研究結果顯示，失語症組與正常健康組在LOTCA-II的總分（p＜0.001）及部分分測驗分數達顯著差異。失語症個案在工作記憶、算數、理解以及推理的能力表現明顯差於正常人。另外，失語症組LOTCA-II與CCAT的總分呈高度正相關（r=0.750 和0.872）。結論　認知功能缺損時，會影響語言表現；語言能力缺損會造成許多功能障礙。失語症的個案具有認知缺損，受語言表現障礙之影響，較難評估其認知缺損之程度，以至於影響其復健治療成效。LOTCAII與CCAT此兩種評估具高度正相關，臨床上針對失語症個案可藉由LOTCA-II來了解其認知狀況，有助於復健治療的介入。

關鍵字

語言 ； 失語症 ； 認知功能

並列摘要

Purposes In patients with aphasia, assessments that focus exclusively on cognitive status and learning ability are insufficient because of the patients’ difficulties associated with listening comprehension, reading, and expressiveness in these assessments, which interfere with the accuracy of the assessments. Our goal is to investigate cognitive ability in patients with mild-to-moderate aphasia in order to understand their learning potential and to analyze the relationships between cognition and language. The study’s results will be helpful in designing and adjusting treatment plans for patients with aphasia. Methods Subjects were divided into normal adult and aphasia groups. Mini Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment II (LOTCA-II) scores were assessed in both groups. The individuals in the aphasia group were also assessed using the Concise Chinese Aphasia Test (CCAT) in order to understand the severity of their language disorders. The main aims of this study were to evaluate the performance of subjects in the aphasia group in the LOTCA-II sub-items, to determine whether there are significant differences between the aphasia group and the normal group in LOTCA-II scores, and to analyze the aphasia group’s LOTCA-II and CCAT scores to investigate their relevance. Results The results indicate that LOTCA-II scores are significantly different (p＜0.001) between the aphasia group and the normal group. The patients with aphasia had significant deficits in working memory, arithmetic, comprehension, and logical reasoning compared to the normal subjects. In addition, language and cognitive function had close relationships (r=0.750 and 0.872, respectively). Conclusions Here, we found that the more severe the language impairment is, the poorer the cognitive performance will be. It is difficult to assess the degree of cognitive impairment among patients with aphasia, as the effectiveness of rehabilitation therapy affects these results. The assessment efficacy of LOTCA-II and CCAT are highly and positively correlated. In the clinic, LOTCA-II can be used to understand the cognitive status of patients with aphasia. This may contribute to the intervention strategy during rehabilitation.

並列關鍵字

Language ； Aphasia ； Cognitive function