老年髋部手术患者记忆障碍临床研究

选择在我院行髋部手术的老年患者95例,均在围手术期接受韦氏记忆得分（WMS）评估,另选择57例健康对照者。发现老年髋部手术患者术后长时记忆中的顺数、倒数和累加评分值,短时记忆中的回忆和视觉再生评分值,瞬间记忆中背数和记忆商的评分值均明显低于对照组。     

计算机辅助技术对血管性痴呆患者的认知康复的疗效观察

目的观察计算机辅助技术对血管性痴呆(vascular dementia,VD)患者的认知康复的疗效。方法将38例符合纳入标准的VD患者随机分为对照组和训练组,每组19例患者。对照组和训练组均给予规范抗痴呆药物治疗、常规康复训练。训练组在此基础上接受计算机辅助认知康复训练,1次/天,30分/次,治疗8周。分别于训练前、训练8周后采用简易精神状态量表(Mini-metal State Examination,MMSE)、蒙特利尔认知评估量表中文版(Montreal cognitive assessment,MoCA)对两组患者进行认知功能评定。比较训练组和对照组治疗前后的组内及组间成绩。结果计算机训练组及对照组MMSE、MoCA总分均比训练前提高(P<0.05);计算机训练组成绩高于对照组(P<0.01);轻、中度VD患者成绩提高明显(P<0.05),重度VD患者成绩提高无统计学差异(P>0.05)。结论规范的抗痴呆药物治疗可以改善VD的认知功能;药物联合计算机辅助技术训练,改善VD认知功能更显著;认知康复训练对改善轻、中度VD患者的认知功能效果显著,对重度VD患者疗效欠佳。     

经颅磁刺激治疗阿尔茨海默病患者记忆障碍的疗效观察

目的探讨重复经颅磁刺激(r TMS)对阿尔茨海默病(AD)患者前瞻性记忆障碍的改善情况。方法回顾性分析2016年12月至2017年6月南充市身心医院精神科接受治疗的前瞻性记忆障碍AD患者60例,根据其治疗方式分为常规治疗组和r TMS组,常规治疗组患者口服康复春口服液,r TMS组患者口服药基础上给予r TMS,2组患者均接受4周治疗。比较2组患者治疗前后认知功能、日常生活能力和血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平差异。采用SPSS 11.5统计软件对数据进行分析,组间比较采用t检验、单因素方差分析或χ2检验。结果治疗前,2组患者认知功能差异无统计学意义(P0.05)。治疗后,r TMS组患者相比常规治疗组定向力[(4.41±1.02)vs(3.56±0.95)分]、瞬时记忆[(4.78±1.25)vs(3.11±0.74)分]、注意力和计算[(3.97±1.12)vs(2.55±1.02)分]、短时记忆[(1.95±0.21)vs(1.32±0.13)分]、语言[(5.68±1.98)vs(4.42±1.52)分]以及视觉空间感觉[(4.87±1.35)vs(3.58±1.12)分]认知功能得分增高,日常生活能力得分也明显增高[(97.25±8.91)vs(70.52±7.14)分],差异具有统计学意义(P0.05)。r TMS组患者治疗后相比常规治疗组TNF-α[(18.48±2.68)vs(23.87±3.11)ng/L]、IL-6[(7.03±1.03)vs(9.35±1.12)mg/L]水平降低,差异具有统计学意义(P0.001)。2组患者在治疗过程中未发生头痛、耳鸣等不良事件。结论 r TMS对AD患者有较好的治疗效果,可改善患者认知功能和日常生活能力,且无不良反应发生。     

老年人的记忆障碍及治疗

记性不好或健忘是老年人经常碰到的问题。许多老年朋友抱怨记忆不如以前好，有前事后忘的感觉。不少人因此而忧虑，担心是否患有老年期痴呆症。这种担心并非没有道理，的确，记忆减退特别是近记忆减退往往是老年痴呆的最早表现。痴呆是一种脑功能障碍综合征，指既往已获得的认知功能的减退或丧失。记忆只是认知功能的重要组成部分之一。因此，老年人记性不好并不一定就意味着患有痴呆，应视具体情况具体分析。     

康复训练治疗老年血管性痴呆的疗效及对认知功能障碍的影响

目的 探讨康复训练治疗对老年血管性痴呆(VD)的治疗效果以及对认知功能障碍的影响.方法 将该院2009年2月至2011年9月诊治的80例老年VD患者随机分成实验组和对照组,对照组40例通过常规药物进行治疗,实验组40例在对照组治疗的基础上进行康复训练治疗.在治疗前后对两组患者进行MMSE评分及HDS评分,对其结果进行分析比较.结果 两组治疗后MMSE评分及HDS评分比治疗前明显提高(P＜0.05).治疗前实验组与对照组MMSE评分及HDS评分比较,无统计学意义,治疗后实验组的MMSE评分及HDS评分明显比对照组高(P＜0.05).结论 在常规治疗的基础上进行康复治疗,可以使老年VD患者治疗效果得到有效的提高,并使认知功能障碍得到有效的改善,对于提高老年痴呆患者的生活质量具有重要的临床意义.     

记忆训练对社区记忆障碍老年人的干预效果

目的 通过"记忆训练处方"对记忆障碍老年人干预效果进行评价.方法 随机选取社区60名Rivermead行为记忆测验评分＜22分的老年人,随机分为干预组和对照组各30人,干预组运用"记忆训练处方"进行针对性训练,对照组任其自然发展,3个月后评分.结果 实验组Rivermead行为记忆测验标准分值及各维度分数较干预前明显提高(P＜0.05).对照组3个月前后无差异(P＞0.05).干预3个月后实验组Rivermead行为记忆测验评分9项明显好于对照组(P＜0.05).结论 个性化的"记忆训练处方"可以改善老年人记忆力,值得社区推广.     

一般老年人群记忆障碍的现状研究

记忆力减退是老年人的常见症状。国外报道 ,中老年人群中 40 %左右主诉有记忆减退〔1 ,2〕;更有认为 76 %的老年人主诉有记忆下降 ,客观记忆检查依据测验的不同异常率可达 32 %～78%〔3〕。国内对于老年人记忆减退发生率还缺乏专门的调查。本文对一组老年人群的调查结果分析记忆减退的主观评价及短时记忆的客观检查。1　材料与方法资料来源于北京市科委资助课题“老年期痴呆的研究”分课题——老年期痴呆的流行病学调查。该课题于 1997年以分层整群随机的方法在北京城乡调查 6 0岁以上老年人 2 788例。老年人由来自医学院毕业生的调查员经统…     

阿尼西坦治疗脑梗塞记忆障碍的疗效观察及对脑电图影响

应用阿尼西坦对４４例脑梗塞恢复期记忆障碍病人进行了临床治疗并观察了对脑电图的影响。结果发现：总有效率达７２．７２％，明显高于对照组（Ｐ＜０．０５），治疗后记忆商（ＭＱ）升高，与治疗前和对照组比较差异极显著（Ｐ＜０．００１），治疗后脑电图鼻常率下降２６．２１％（Ｐ＜０．０５）。提示阿尼西坦具有改善记忆和脑电图的作用     

老年脑梗死患者记忆功能及患病与记忆障碍的相关性

<正>老年人的认知功能随着年龄的增长而下降,除生理性变化外由某些慢性疾病引起的大脑器质性病理改变(如脑梗死)也是影响认知功能的重要原因。研究发现脑卒中患者3¹5个月内发生认知功能减退者超过30%,其中9%可发展为痴呆〔1〕。在认知功能障碍中记忆障碍为著。本文旨在研究老年脑梗死患者记忆障碍特点及类型。1对象与方法1.1对象2010年4月至2011年4月河北联合大学附属医     

老年记忆障碍与前额叶功能

额叶是大脑发育中最高级的部分,它包括初级运动区、前运动区和前额叶（ｐｒｅｆｒｏｎｔａｌｃｏｒｔｅ,ＰＦ）,其中ＰＦ与认知功能关系密切。前额叶又分为眶部、背部、内侧部和外侧部,其中眶部和内侧部、背部和外侧部的结构和功能较为接近。ＰＦ与大脑其它区域有着密...     

早期康复治疗对脑卒中偏瘫病人运动功能及ADL的影响

目的探讨早期康复治疗对脑卒中病人运动功能和日常生活活动能力(ADL)的影响。方法将88例脑卒中偏瘫病人随机分成康复组(43例)和对照组(45例)进行临床对照研究,两组均进行常规神经内科药物治疗,康复组加以康复治疗。每例病人入组时、治疗第30天分别用Fugl-Meyer运动功能量表(FMA)测试运动功能和改良Barthel指数量表(BI)测试ADL。结果康复组及对照组治疗后的BI值和FMA值均比治疗前明显增高(P<0.05或P<0.01),治疗后康复组比对照组的BI值和FMA值明显增高(P<0.05)。结论早期康复治疗对脑卒中偏瘫病人运动功能和ADL具有明显的改善作用,可提高其生活质量。     

早期康复训练对老年脑卒中患者日常生活活动的影响

目的探讨早期康复对老年脑卒中患者日常生活活动(ADL)能力的影响。方法采用改良Barthel指数(MBI)对发病4周内的老年(46例)及非老年(32例)脑卒中患者在康复治疗不同阶段的ADL能力进行评定比较。结果①老年康复组及对照组的各项ADL能力在入组时无显著性差异。入组1月末,老年康复组的修饰、穿衣能力优于对照组(P<0.05);入组3月末,除二便控制及洗澡、进食能力外,老年康复组的其他ADL能力均优于对照组(P<0.05)。②老年康复组的小便控制、转移及步行能力在入组时较非老年康复组低下(P<0.05);入组1月末,老年康复组的用厕、步行、穿衣及上下楼梯能力仍较非老年康复组显著低下(P<0.05);入组3月末,2组的各项ADL能力无显著性差异。结论早期康复有利于改善多数老年脑卒中患者的ADL能力。     

Serum concentrations of dehydroepiandrosterone sulfate (DHEA-S) in oldest old Japanese women correlate with cognitive activity rather than activities of daily living

Background:   Dehydroepiandrosterone (DHEA) and its interconvertible sulfate ester, DHEA sulfate (DHEA-S), mainly produced by the adrenal glands, are progressively decreased with aging and are proven markers of longevity. Although serum level of DHEA (-S) has been shown to be decreased in dementing diseases, the issue remains controversial. We investigated the physiological significance of DHEA-S in oldest old Japanese women in respect of activities of daily living (ADL) or cognitive activities.
Methods:   Cross-sectional study of 50 women aged 90–103 years old. Serum concentrations of DHEA-S levels were measured by radioimmunoassay. ADL and cognitive activity were evaluated by the Bathel index and revised Hasegawa's dementia rating scale (HDS-R), respectively. Univariate or multivariate regression analyzes were used for statistics.
Results:   Of the 50 subjects, 80% exceeded the lowest level of the normal range for women in their forties. Serum concentrations of DHEA-S were significantly correlated with HDS-R but not with the Barthel index.
Conclusion:   Relatively higher levels of serum DHEA-S in oldest old women may reflect the longevity of this population and the levels might be associated with cognitive activity rather than ADL.     

Cognitive Functioning in Relation to Self-Care in Elderly Persons with a Bipolar Disorder

This study explores which aspects of cognitive functioning may influence the self-care and independence of older patients with a bipolar disorder and whether there is a correlation between characteristics of the disease and self-care. Patients completed a comprehensive neuropsychological battery and filled in a questionnaire on activities of daily living and instrumental activities of daily living. Results indicate that (compared with age-matched norm scores) this group of euthymic patients performed worse on tests of attention, verbal memory, and executive functioning. Tests of attention and executive functioning were related to self-care. Attention and aspects of verbal memory were related to characteristics of the disease. The findings suggest that aspects of attention, memory, and executive functioning are associated with activities of daily living and instrumental activities of daily living.     

Effect of home-based reablement program on improving activities of daily living for patients with stroke: A pilot study

Background:Administering activities of daily living (ADL) and recovery of ADL functions are the main treatment goals in rehabilitation for patients with stroke. Reablement is one form of rehabilitative intervention, which aims to restore ADL functions performed in the community. The purpose of this study was to investigate the effects of home-based reablement from 3 concepts of ADL (ie, actual performance, ability, and self-perceived difficulty) for patients with stroke.Methods:This was a single-blind pilot randomized clinical trial. Twenty-six patients were randomly assigned into 2 groups: home-based reablement group (n = 12) and control group (n = 14). The home-based reablement group received ADL training in the home environment for 6 weeks. The control group received conventional rehabilitation in the hospital. Outcome measures contained the Canadian Occupational Performance Measure (COPM) and the Barthel Index-based Supplementary Scales (BI-SS). The COPM was applied to identify patients’ level of performance and satisfaction with ADL training. The BI-SS included 3 ADL scales: actual performance, ability, and self-perceived difficulty.Results:The patients in the home-based reablement group showed statistically significant improvements in the ability scale and total score of the BI-SS than the control group (P < .05) and demonstrated moderate effect size (success rate difference = 0.34–0.42). No significant differences were noticed in the COPM and the other 2 scales of the BI-SS (actual performance and self-perceived difficulty), but small effect sizes were found (success rate difference = 0.17–0.22).Conclusions:For patients with stroke, the 6-week home-based reablement program had similar effects with the control group on patients’ perceived performance, satisfaction, and difficulty in ADL, but it displayed potential for enhancing their ability in executing ADL tasks.     

The Glittre ADL-Test Differentiates COPD Patients with and without Self-Reported Functional Limitation

Abstract

The Glittre ADL-test is based on important and common activities of daily living (ADLs), and it is an useful test to objectively distinguish patients with and without self-reported functional limitations. This study aims to analyze if difficulty to perform ADLs, as self-reported by patients with COPD, would reflect a worse Glittre ADL-test performance. In the first visit, patients were evaluated for clinical and nutritional status, spirometry, maximal cardiopulmonary exercise test on a treadmill. One week later, the patients performed two Glittre ADL-tests. Maximal voluntary ventilation (MVV) and the VE_Glittre/MVV, VO_2Glittre/VO_2peak, and HR_Glittre/HR_peak ratios were calculated to analyze the ventilatory, metabolic, and cardiac reserves. The London Chest Activity of Daily Living (LCADL) scale was only answered after the two Glittre ADL-test were performed. Patients were splited into two subgroups based on the anchor question of the LCADL: those with and those without self-reported ADL limitation. Sixty-two COPD patients were included (65.3?±?8.6?years, FEV₁ 62?±?22%pred). Those with ADL limitation (39 patients) completed the Glittre ADL-test with a significantly longer time (p?=?0.002), as well as higher VE_Glittre/MVV (p?=?0.005) and lower oxygen pulse (p?=?0.021) than those without ADL limitation. The time spent to perform the Glittre ADL-test was significantly associated with total LCADL score (ρ?=?0.327, p?<?0.05). A cutoff of 253?s was able to distinguish those patients without and with ADL limitation. COPD patients who self-reported ADL limitation according to the LCADL scale took a longer time to perform the Glittre ADL-test with higher VE_Glittre/MVV and lower oxygen pulse than those without ADL limitation.     

What is the factor that most influences QOL among rheumatoid arthritis patients?

We attempted to elucidate the factors which affect the quality of life (QOL) among patients with rheumatoid arthritis (RA). Ninety-five patients who satisfied the American Rheumatism Association criteria for RA were asked to fill in a modified arthritis impact measurement scale, version 2 (AIMS2) and complete a Lorish's face scale (FS) test. The same questionnaire and FS test were completed by 75 healthy persons as controls. We used Lorish's FS for our assessment of QOL. The investigation was undertaken to analyze the relationship between FS and each item on the questionnaire. For average FS score, there was no significant difference between the RA group and the controls. However, RA group scores covered a wider range than those of the controls. From the correlation analysis, physical stress, pain factors, and some of the activities of daily living (ADL) factors showed a strong correlation with FS. ADL factors which strongly correlated with FS were those related to activities of the lower limbs. Other ADL factors were moderately correlated with FS. Socioeconomic factors were not significantly correlated with FS. There was no significant difference between the QOL of RA patients and that of healthy controls. The QOL was correlated with pain and stress factors rather than with ADL factors among patients with RA. Received: June 9, 2000 / Accepted: October 23, 2000     

日常生活受限的老年患者营养状况的调查

目的:调查日常生活活动能力下降的老年患者的营养状况。方法:使用简易营养评价简表(MNA-SF)评估我院干部病房住院老年患者的营养状况,并按照日常生活自理能力程度分为4组进行分析。结果:共53例患者纳入研究,23(43.40%)例患者发生营养不良,且4组随着日常生活自理能力下降,MNA-SF评分(营养不良发生率)分别为13.00±1.30(4.76%),10.13±1.64(62.50%),9.40±2.50(60.00%),7.36±3.15(76.57%)(P<0.05)。简易营养评价简表评分和白蛋白、前白蛋白、血红蛋白具有良好的相关性。结论:老年患者随着日常生活自理能力的下降,其营养不良发生率逐渐增加,MNA-SF可以用于这类人群营养不良的筛查。