前田 晃子

Mobile phones are increasingly being proposed as tools to support daily life among older adults with cognitive impairment; however, empirical data on their actual ownership and use in clinical settings remain limited. This study aimed to clarify mobile phone ownership and usage patterns among older adults with cognitive impairment attending memory clinics. Eighty-two older adults with cognitive impairment (mean age: 80.4 y; mean Mini-Mental State Examination score: 18.1 points) were included. Data were collected using caregiver-administered questionnaires and analyzed descriptively. Among the participants, 65 (79.3%) owned a mobile phone, with an almost equal distribution of smartphones (n=33) and featured phones (n=32). Fifteen phone owners did not use their devices. Reported use was largely limited to basic communication functions. These findings indicate limited mobile phone ownership and functional use among older adults with cognitive impairment and underscore the need to consider cognitive limitations when implementing mobile technologies.

A BSTRACT Introduction: The coronavirus disease 2019 pandemic prompted widespread restrictions on daily activities, leading to concerns over delayed medical consultations. However, limited social interaction outside the home may have increased the time family members spent with older adults, potentially facilitating earlier detection of dementia symptoms. This study aimed to examine changes in dementia severity, cognitive function, and caregiver burden at initial visits to a memory clinic before and during the pandemic and compare the patterns of initial visits to outpatient memory clinics. Materials and Methods: In total, 378 patient-family pairs (200 before and 178 during the pandemic) were evaluated at their first clinic visit. Cognitive function, dementia severity, and caregiver burden were assessed. Group comparisons were conducted using the Mann-Whitney U and χ ² tests. Results: While cognitive test scores and caregiver burden were similar between the two periods, patients who visited during the pandemic exhibited significantly lower dementia severity (clinical dementia rating: P = 0.001). The correlation between observed dementia severity and cognitive function remained strong in both periods. Conclusion: Contrary to expectations of delayed care, the pandemic period was associated with earlier clinical visits for patients with milder dementia. These results suggest that increased contact between family members and patients provided more frequent opportunities for support and intervention, which prevented a decline in activities of daily living among patients with the same cognitive impairment.

Background: Because dementia is a long-term condition, the appropriate involvement of health-care professionals is considered important. However, little is known about the factors associated with changes in family caregiver burden. Objective: To clarify changes in family caregiver burden and associated factors during follow-up at a memory clinic. Methods: A retrospective cohort study was conducted, enrolling 495 pairs of patients with dementia or mild cognitive impairment and their family caregivers. A total of 120 pairs completed the second evaluation. The caregiver burden was assessed using the Zarit Burden Interview (ZBI). Data at the initial visit and after an average follow-up of about 2 years were compared and analyzed. Results: At initial visit, the patients’ mean age, Mini-Mental State Examination (MMSE) and ZBI scores were 78.6±5.6 years, 23.3±3.5, and 22.6±16.7, respectively. At follow-up, MMSE scores decreased (21.4±4.5, p < 0.001), but ZBI scores remained similar (22.5±13.6). When the difference in ZBI scores between the two time points was defined as ΔZBI, and the related factors were analyzed by multiple regression analysis, ZBI scores at the initial visit, start of psychotropic drug, and decrease of neuropsychiatric symptoms were identified as significant factors ( p < 0.001, p = 0.003, p < 0.001, respectively). A significant negative correlation was found between ZBI scores at the initial visit and ΔZBI ( r = –0.588, p < 0.001). Conclusions: These findings suggest the importance of assessing changes in the burden experienced by family caregivers during the disease follow-up.

OBJECTIVES: The purpose of this study was to capture the lifestyle characteristics of traumatic brain injury (TBI) patients by administering the Frenchay Activities Index (FAI), a self-assessment questionnaire used for assessing life-related activities, among TBI patients. METHODS: This study was conducted using the revised FAI Self-Assessment Form, administering an interview-based questionnaire survey to TBI patients and healthy participants. The target group comprised 60 traumatic brain injury patients who had progressed from at least 1 year since the injury, with a comparison group of 788 healthy participants. RESULTS: A comparison of FAI scores between TBI patients and healthy participants by questionnaire revealed that TBI patients exhibited significantly higher FAI scores than healthy participants for outdoor walking and transportation use (Mann-Whitney U test, P<0.01). A comparison by occupation revealed that TBI patients were significantly less among the unemployed and other categories (Mann-Whitney U test, P<0.01). For office workers, government employees, high school students, and college students, scores were higher among TBI patients compared with healthy participants, although the differences were not significant. CONCLUSIONS: Although TBI patients were less active than healthy participants in life-related activities, their scores for cleaning up after meals and cleaning and putting things in order were close to those of healthy participants, indicating that TBI patients cannot be considered to be inactive. The findings also revealed differences in TBI patients' engagement in life-related activities and frequency of activities depending on their social position.

OBJECTIVE: To evaluate the effectiveness of a dyadic outpatient rehabilitation program focused on improving the real-life daily activities of patients with mild cognitive impairments or dementia and their caregivers. DESIGN: Retrospective study. SUBJECTS: Eight patients with mild cognitive impairments or dementia and their caregivers. METHODS: The rehabilitation program comprised eight 1-hour sessions by occupational therapists with patients and his/her caregivers. Patients were assessed for motor function, cognitive function, and quality of life, and their caregivers were assessed for depression and caregiver burden. Participants were assessed at pre-program and post-program, and 3-month follow-up. RESULTS: The scores of caregiver-assessed Quality of life in Alzheimer's disease scale in patients significantly improved at post-program (median [interquartile range], 30.0 [7.0]) compared with pre-program (27.0 [2.8], effect size = 0.77, p = 0.029). In caregivers, the Zarit Caregiver Burden Interview scores decreased significantly at post-program (16.5 [13.0]) compared with pre-program (22.0 [17.5], effect size = 0.72, p = 0.042). There were no significant differences in other assessments. CONCLUSIONS: The rehabilitation program focused on real daily activities and demonstrated to improve patients' quality of life and caregivers' depression and caring burden through patient-caregiver interaction. Future enhanced follow-up systems are warranted.