Japanese Journal of Geriatrics最新文献

Purpose: This study aimed to develop an educational program for doctors and nurses who treat and care for older adults with dementia and delirium, based on a person-centered care program, utilizing virtual reality (VR) and augmented reality (AR).

Methods: A VR/AR-based program was implemented from February 16 to June 10, 2023, and participants were asked to complete questionnaires before the intervention, immediately after, and three months later.

Results: This study included 74 participants, including 61 nurses (84.2%) and 13 doctors (17.6%). Confidence in delirium care significantly increased for both nurses and doctors immediately after the intervention and one month later relative to baseline. However, knowledge of delirium did not show significant improvement in either nurses or doctors. In the Approaches to Dementia Questionnaire, nurses showed significant improvement in the domain of "personhood" and their total score after one month relative to baseline. The total score of doctors only improved immediately after the intervention relative to the baseline score. In the Team Approach Assessment Scale-Revised, nurses showed significant improvement in the domain of "clarification of goals and roles" and the total score of nurses at one month relative to baseline, while physicians showed no significant improvement.

Conclusion: The program using VR/AR to experience the viewpoints of elderly individuals with dementia and the experiences of multiple professions in this study significantly improved nurses' practice and awareness of person-centered care for older adults with dementia, and nurses' and physicians' confidence in their treatment and care for delirium. Moreover, the study highlights the necessity of incorporating interventions that draw upon the expertise of various professions within dementia care programs to promote multidisciplinary collaboration.

Aim: Previous studies have reported that migration is associated with cognitive impairment, and that disconnections from local communities affect cognitive function. This study examined the association between the duration of residence and cognitive impairment.

Methods: The survey consisted of designed a 4-year longitudinal study that was conducted in 2013 and 2017 in Kami Town, Hyogo Prefecture, Japan. Among the 3,605 completed questionnaires, 2,051 were selected, excluding those with cognitive impairment in 2013 and/or missing data. The duration of residence until 2013 was categorized as ≤ 5 or ≥ 6 years. Cognitive impairment was defined as a person who was determined to have cognitive decline on the Kihon checklist. Odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive impairment were calculated according to sex and participation in community activities using multivariate logistic regression analysis after adjusting for age, mobility impairment, and depression.

Results: Of the 2,051 respondents, there were 1,299 women (63.3%; mean age, 74.1±6.2 years old) and the prevalence of cognitive impairment was 514 (25.1%). Multivariate logistic regression showed that women with a residence duration ≤ 5 years were more likely to have an impaired cognitive function than a residence duration ≥ 6 years; the adjusted ORs (95%CIs) were 1.65 (0.55-4.91) in those who participated in community activities and 3.86 (1.33-11.24) in those who did not. In contrast, no significant association was observed among the men.

Conclusion: This finding suggests that among community-dwelling older adults, women who have lived in the community for less than 5 years and who do not participate in community activities may be at increased risk of deterioration in the cognitive domains of the KCL after 4 years.

Aim: The cognitive function is important for activities of daily living (ADL). However, few studies have examined the association between the cognitive function and diaper use in patients admitted to convalescent rehabilitation wards. This study aimed to identify the association between suspected dementia and the transition from diaper use in patients admitted to convalescent rehabilitation wards.

Methods: We conducted a retrospective cohort study of patients admitted to convalescent rehabilitation wards across nine hospitals, all of whom used tape diapers. Suspected dementia was defined as a score of ≤20 on the revised Hasegawa Simplified Intelligence Scale, and transition from diaper use was defined as the use of rehabilitation or cloth pants. A binomial logistic regression analysis was used to examine this association between suspected dementia and the transition from diaper use.

Results: We included 100 patients with cerebrovascular disease (male, 52%; median age, 81 years; prevalence of suspected dementia, 65%), 112 patients with musculoskeletal disease (male, 22.3%; median age, 87 years; prevalence of suspected dementia, 40.2%), and 52 patients with disuse syndrome (male, 46.2%; median age, 85 years; prevalence of suspected dementia, 75%). Suspected dementia was significantly associated with the transition from diaper use in patients with cerebrovascular disease (adjusted odds ratio[aOR], 0.30; 95% confidence interval[CI], 0.11-0.86; p=0.024), musculoskeletal disease (aOR, 0.15, 95% CI, 0.05-0.46; p<0.001), and disuse syndrome (aOR, 0.10; 95% CI, 0.01-0.79; p=0.029).

Conclusions: Suspected dementia was negatively associated with transition from diaper use in patients admitted to convalescent rehabilitation wards. The assessment of suspected dementia may be useful in determining intervention policies for transitioning from diaper use.