住民主体の認知症予防活動をめざした実践的研究 : 認知症予防活動の継続活動者と非継続活動者の比較からの支援方法の検討

Abstract

研究の背景 高齢化が進む今日、認知症予防の対象高齢者は多く、行政や保健所による専門的なスタッフでの対処では限界がある。そのため、地域住民が認知症予防の方法を学んで主体的に地域に広めていくことが望ましい。本地域では、健康教育の一環として、地域住民が主体的に継続活動できる認知症予防を目指し実践している。 研究目的 健康推進事業として提供した認知症予防が事業後も住民に継続して取り入れられ地域に根付いていくため、健康推進事業としての支援方法を、活動を継続した者と活動を継続しなかった者の相違に着眼し検討を行った。 研究方法 認知症予防事業に参加し機能測定に対する協力と情報提供があった72名を対象とし、認知症予防事業後1年以内の活動状況を調査する。体験教室を機会に認知症予防としての活動を継続している者としていない者に対して、認知症予防事業の評価として設定した認知機能・身体運動機能・社会的機能などの変化と、認知症予防教室の開催場所や開催内容についての相異を明らかにする。 結果 体験教室を機会に認知症予防としての活動を新たに増した者は47名(65.3%)、活動をしなかった者は25名(34.7%)であった。活動の内容をみると、既存の生涯学習グループに参加した者2名(2.8%）、高齢者介護予防のディサービスに参加した者6名(8.3%)、自分たちでグループを形成し活動している者39名(54.2%)であった。音楽療法教室とレクリエーション教室の種類に活動率の差はなかった。しかし、機能面の変化では、活動を増した者は認知機能面だけではなく、身体運動機能面や社会的機能面など複数の機能に改善を認めた者であった。

Background In today's aging society, many elderly persons require prevention of dementia, and thus there are limits to handling by professional staff at health centers and other governmental organizations. Therefore, it is desirable that local residents learn how to prevent dementia and voluntarily promote preventive measures in their communities. In the community described in this report, subjects aim at and implement prevention of dementia through local residents' voluntary and continuous activities as part of ongoing health education. Objective As a provider of health promotion activities, we considered how to support dementia prevention by comparing persons who continued the activities for dementia prevention with those who did not, so that the program for prevention of dementia provided as part of health promotion activities would take root in the community and be continued by local residents after the program completed. Method Seventy-two persons participated in the program for the prevention of dementia, cooperated in function measurements, and provided information. We investigated the status of the activities conducted within one year of completion of the program for prevention of dementia. Specifically, we attempted to find differences between persons who continued the activities for prevention of dementia after an on-site seminar and those who did not, with respect to changes in cognitive functions, body movement, and social functions (these were the parameters used to evaluate the program for prevention of dementia), as well as the location and program of the seminar for prevention of dementia. Results Forty-seven persons (65.3%) newly started activities for the prevention of dementia after an on-site seminar, while 25 persons (34.7 %) did not. The details of the activities are as follows: 2 persons (2.8%) joined existing lifelong learning groups; 6 persons (8.3%) participated in day-services for minimizing care needs of elderly persons; 39 persons (54.2%) organized groups and did activities on their own. There was no difference in the percentage of persons engaged in activities between music therapy class and recreation class. However, an assessment of changes in function revealed that persons who newly started their activities also showed improvement not only in cognitive functions but also in various other functions as well, including body movement and social functions. Conclusions More than 60% of participants continued the activities after completion of the program for prevention of dementia. This indicated that our intention of health education was conveyed to the local residents. Persons who continued the activities experienced improvement in more than one function. Parameters should be provided so that such persons can recognize the effects of their activities.