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.