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急性ケアと重症病の入院と高齢者の認知機能との関連
William J Ehlenbach1, Catherine L Hough, Paul K Crane
1Department of Medicine, University of Washington, Seattle, USA. wje1@u.washington.edu
JAMA
|February 25, 2010
まとめ
急性または重症疾患の入院は,高齢者の認知機能低下を増加させます. 非重症疾患の入院は,認知症を発症するリスクが高いと関連しています.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 神経学 神経学とは
- クリティカルケア・メディシン
背景:
- 深刻な病気の生存者は,しばしば長期的な認知障害に直面します.
- 以前の研究では,先発性認知機能の測定と認知症リスク評価が欠けていました.
- 認知症のリスクに対する重症病の影響は,まだ十分に研究されていない.
研究 の 目的:
- 急性ケアまたは重症病の入院後の高齢者の認知機能低下を比較するために,入院と入院なしを比較する.
- 入院の被曝がインシデント認知症のリスクを変化させるかどうかを評価する.
主な方法:
- 認知症の発症のないコミュニティに住む2929人の高齢者 (≥65歳) の前向きなコホート研究 (1994年−2007年).
- 認知機能は,認知能力スクリーニング装置 (CASI) を使って2年ごとに評価されます.
- インシデント認知症は,CASIスコア <86.6の患者に対する臨床検査で診断される.
主要な成果:
- 急性ケアのための入院は,平均CASIスコア1.01ポイント低い (P < .001) と関連していました.
- 重症病入院は,平均CASIスコアが2.14ポイント低いことと相関していた (P = .047).
- 非重症性疾患の入院により,認知症のリスクが増加した (HR,1.4;P = .001).
結論:
- 急性または重症で入院した高齢者は,入院していない同級生よりも認知能力の低下が大きいことを示しています.
- 非重症性疾患の入院は,認知症を発症させる重要なリスク因子です.
- 病院での入院経験は,高齢者の長期的認知健康に影響を及ぼします.
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