阿茲海默氏症病人的路徑測試表現與視覺空間功能之相關

The Relationship between the Route Task Performance and Visuospatial Functions in Alzheimer Disease Patients

陳惠媚(Hui-Mei Chen) ； 劉景寬(Ching-Kuan Liu) ； 張志仲(Jyh-Jong Chang)

《職能治療學會雜誌》 20卷 (2002/11) Pp. 39-48

https://doi.org/10.6594/JTOTA.2002.20.04

摘要

認知功能普遍下降為阿茲海默氏症病患主要症狀，疾病初、中期並不會影響病患的動作能力，但會影響行動的安全性（如獨自外出）；本研究主要目的是利用一項路徑測試，了解輕、中度失智且能行走的阿茲海默氏症病患空間定向功能之表現，並探討預測此功能的重要變項。
本研究以二十四位的歲以上的輕、中度失智，且可行走的阿茲海默氏症病人為病人組，正常老人組為病人的配偶或年齡相似之家屬共二十三 位。施測的材料與工具，包括路徑測試、記憶測驗、空間知覺功能測試、空間結構操作測試；以t檢定(Independent t-test)、卡方檢定與區辨分析分析資料。研究結果發現去程與回程路徑測試中，在去程兩組未達顯著差異， 回程兩組有達顯著差異；進而由區辨分析結果得到，回程出現錯誤的預測變項有兩項，近期記憶與空間知覺能力。
本研究的結論有兩項：一、可行走的阿茲海默氏症病人，在本研究的路徑測試表現差於正常老人，且發現在具有中間結構連接( structural link)的環境地形(landmark) ，如樓層別或不同轉彎處，會增加病人學習新路徑的困難度。二、病人的空間知覺與近期記憶能力，可作為預測阿茲海默氏症病患空間定向功能之重要變項。

關鍵字

阿茲海默氏症,路徑測試表現,視覺空間功能

並列摘要

The major symptoms of Alzheimer's disease (AD) are various kinds of cognitive decline dysfunctions. Patients at the early to middle stages didn’t show physical motor movement impairment, cognitive dysfunction would threaten the safety of their mobility (e.g., go outside alone). This study aims at understanding the ability of the topographic orientation in ambulatory patients with Alzheimer's disease by using a route task and examining the predict factors of function of topographic orientation.
Twenty-four ambulatory patients with mild-to-moderate Alzheimer's disease and 23 healthy elderly were recruited. All subjects needed to performance two route tasks (forward and backward trials). memory tests. spatial perception tests. visuo-construction test. Independent t-tests, chi-square test and discriminant analysis were used in data analysis.
There were no significant differences between AD and normal elders during forward trial. However it showed significant differences between AD and control groups during backward trial. Further discriminate analysis identified two predictors, short-term memory and space perception ability of AD patients in the backward trial of the route task.
Our findings suggest that: 1) performance on the route task in ambulatory AD patients is significantly worse than normal elders. Especially the landmarks with structural link would increase the difficulties of learning new route for AD patients. 2) the short-term memory and spatial perception ability of AD patients are the major predictors for their function of topographic Orientation.

並列關鍵字

Alzheimer's disease,route task performance,visuospatial function