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糖尿病外来における認知症患者の発見と対応
https://nsg.repo.nii.ac.jp/records/3423
https://nsg.repo.nii.ac.jp/records/34239d982b67-9815-4c03-814a-f98bd7fa90a2
名前 / ファイル | ライセンス | アクション |
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KJ00004703867.pdf (919.0 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2010-03-05 | |||||
タイトル | ||||||
タイトル | 糖尿病外来における認知症患者の発見と対応 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Screening and management of the patients with dementia in a diabetes clinic | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 糖尿病 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 認知症 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 認知機能障害 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | チーム医療 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Diabetes mellitus | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Dementia | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Cognitive impairment | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Team medical care | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Diabetes mellitus | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Dementia | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Cognitive impairment | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | Team medical care | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | 糖尿病 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | 認知症 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | 認知機能障害 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | チーム医療 | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
Title in Japanese | ||||||
糖尿病外来における認知症患者の発見と対応 | ||||||
タイトル(英) | ||||||
en | ||||||
Screening and management of the patients with dementia in a diabetes clinic | ||||||
著者 |
堀口, ハル子
× 堀口, ハル子× 松森, 晴美× 近藤, 弘子× 近藤, 甲斐夫× 山本, 通子× Horiguchi, Haruko× Matsumori, Harumi× Kondo, Hiroko× Kondo, Kaio× Yamamoto, Michiko |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 糖尿病も認知症も高齢になるほど罹患率が増加する。高齢化社会の進行につれ糖尿病患者の中で認知症を患う人が増え続けると予想される。有効で安全な糖尿病治療のためには患者の理解力や自己コントロール力などが必要で、認知症患者では療養指導が難しくなる。そこで認知症合併糖尿病患者の症例検討を通して、患者に共通する問題点を考察し認知症疑いの患者を発見する方策を検討した。症例検討では、インスリン治療中患者が認知症を発症した場合に糖尿病コントロールが徐々に悪化する特徴がみられた。認知症疑いの患者を全スタッフが列挙する試みにおいては31人の名前があがり、スクリーニング検査を施行した20例の大半が認知症と診断された。研究対象とした糖尿病外来に通院している患者数は約1, 500人、罹患率から推定される認知症患者数は60人以上となる点を考慮すると、軽症患者がかなり見逃されていることになる。これをいかに発見して診療に役立てるかが今後の課題である。 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | The number of patients with diabetes mellitus or other life-style related illnesses is increasing continuously. At the same time, as the elderly population grows, greater attention has to be paid to the care of people with dementia. It is reported that currently there are approximately 16, 200, 000 people with diabetes mellitus and 2, 000, 000 with dementia in Japan. According to some estimation, the prevalence of diabetes mellitus in people older than 65 years is 1 out of 3 to 4, and that of dementia is 1 out of 10 to 13. Although the exact prevalence of dementia among patients with diabetes mellitus is not known, diabetes mellitus has long been considered a risk factor for the development of vascular dementia and even for Alzheimer's disease. It is conceivable therefore that many elderly people are suffering from both diabetes mellitus and dementia. Health care professionals are challenged by the complex issues involved in caring for a person with dementia and other chronic medical conditions. Among many medical conditions, diabetes mellitus is unique in that self-control of daily life by the patient is essential to the proper management of the disease. However, self-control of daily life becomes a difficult task for a person with dementia due to impairment of cognitive function. Thus a patient with both diabetes mellitus and dementia needs particular attention by health care providers. Understanding of these issues by clinicians and other professional caregivers will improve QOL of the patients and their families. To deal with diabetic patients with dementia, it is important for primary care physicians to detect dementia in its early stage. This paper describes our attempt to detect undiagnosed patients with dementia as well as suspicious borderline cases in our diabetes clinic to which about 1, 500 patients were attending regularly. We first reviewed the case records of patients with diabetes mellitus in whom the diagnosis of dementia had been established. As well known, their clinical course revealed that early signs of dementia were easily overlooked unless we suspected possible cognitive impairment in the patients. We found that one of the clues to suspect dementia in patients under insulin treatment was the worsening of diabetic control due to the failure of injecting correct doses of insulin at indicated times with appropriate procedures. This may reflect that insulin self-injection requires a wide range of cognitive abilities including executive functions. We next conducted standard screening tests to assess the cognitive status of the patients who showed behavioral characteristics suggestive of dementia. Of 20 patients tested, more than half were considered to have either Alzheimer's disease or cerebrovascular dementia. However, it is obvious that many people with mild dementia remain undiagnosed. The number of patients with dementia thus detected was much smaller than that calculated from its prevalence. We need more dependable strategies suitable for general practitioner's office to detect early stage of cognitive impairment. | |||||
書誌情報 |
新潟医療福祉学会誌 巻 6, 号 1, p. 1-8, 発行日 2006-12 |
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出版者 | ||||||
出版者 | 新潟医療福祉学会 | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1346-8774 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AA11614531 | |||||
権利 | ||||||
権利情報 | 本文データは国立情報学研究所により電子化されたものである | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
フォーマット | ||||||
内容記述タイプ | Other | |||||
内容記述 | application/pdf | |||||
資源タイプ | ||||||
内容記述タイプ | Other | |||||
内容記述 | 論文(Article) | |||||
資源タイプ・NII | ||||||
Journal Article | ||||||
資源タイプ・DCMI | ||||||
text |