高齡榮家住民認知功能異常盛行率調查

Cognitive Impairment among Institutionalized Elderly in a Veteran Home

林鉅勝(Chu-Sheng Lin) ； 陳亮恭(Liang-Kung Chen) ； 黃信彰(Shinn-Jang Hwang) ； 藍忠孚(Chung-Fu Lan) ； 唐憶淨(Yih-Jing Tang) ； 劉丕華(Pi-Haw Liu)

《台灣老年醫學雜誌》 2卷4期 (2007/05) Pp. 243-250

摘要

研究背景：認知功能伴隨著年齡的增長而下降，形成長期照護機構的主要照護問題之重要部份。本研究的目的即在探討入住在榮民之家的機構內老年男性認知功能障礙的盛行率及其相關危險因子。
方法：在台北縣一所榮民之家實施斷面研究。基本資料包含年齡、婚姻狀態、教育程度及入住機構時間的長短。每個榮家住民皆接受心智狀況檢查(MMSE)的檢查，接受過六年以下（含六年）教育者其MMSE小於24分或是接受六年以上正式教育者若MMSE小於26分，則判定爲認知功能障礙。所有受試的榮家住民依年齡層區分，每十年分成一組（第一組爲65至74歲，第二組爲75至84歲，第三組爲大於等於85歲）。使用基本資料庫(MDS)爲基礎的「資源利用分組之生活功能評估」(RUG ADL)來評定日常生活功能的狀態。針對連續變項的比較採Student t-test分析、若爲類別變項則採Chi-square test或Fisher's Exact test分析，認知功能障礙的獨立危險因子依前述分析所得者具顯著差異的變項再共同進入多項次羅吉氏迴歸。
結果：總共587位榮家住民參與本研究，平均年齡80.9±5.3歲，全部爲男性。藉由RUG ADL來判定，在所有參與研究的住民中93.4%的日常生活功能獨立。所有住民認知功能障礙比例爲18.6%，在第一組爲9.3%、第二組爲16.8%、第三組爲28.7%。在高教育組及低教育組中認知功能障礙比例分別爲15.8%及20.0%。低教育程度、年紀較大及較差的日常生活功能都與MMSE得分較低顯著相關。
結論：認知功能障礙的盛行率在隨著年齡的增長而顯著上昇，其可能影響生活功能，對老年族群的日常生活照顧更加注意。

關鍵字

認知功能異常 ； 失智 ； 老人 ； 機構式照護

並列摘要

Background: Cognitive function declines with age in the elderly, which may become a important issue in long-term care facilities. The main purpose of this study was to evaluate the prevalence of cognitive deficit and to explore related factors among institutionalized elderly in a veteran home.
Methods: A cross-sectional study was conducted in a Veteran Home in Taipei County. Demographic data including age, marital status, educational status, and time of institutionalization were collected. Mini-Mental State Examination (MMSE) was conducted for each participant. Cognitive deficit was defined as MMSE score ＜24 for participants with education years less than 6 and ＜26 for those more than 6 years of education. All study subjects were stratified into three groups at an interval of 10 years (Gr 1 for 65~74 years; Gr 2 for 75~84 years; Gr 3 for 85 years old). Physical functional status was determined by the minimum data set (MDS) resource utilization group activity of daily living score (RUG ADL). Comparisons of continuous variables were analysed by Student t-test. Categorical variables were analysed by Chi-square test or Fisher's Exact test when appropriate. Multivariate logistic regression was used to determine independent risk factors for cognitive impairment.
Results: A total of 587 residents were enrolled (80.9±5.3 years), all males and 93.4% of them were physical independent by RUG ADL. The average prevalence of cognitive deficit was 18.6% (9.3% in group 1, 16.8 % in group 2, and 28.7% in group 3 respectively). The prevalence of cognitive deficit read respectively 15.8% in the high-education group and 20.0% in the low-education group. Low MMSE score was significantly associated with lower education status, older age and poorer functional status.
Conclusions: The prevalence of cognitive deficit was significantly associated with elder age, rendering cognitive deficit a crucial issue deserving further attention in eldercare.

並列關鍵字

cognitive impairment ； demention ； elderly ； institutionalized care