介護保険制度下での老人性痴呆疾患センターの役割

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The authors reviewed the medical records of 203 cases of people who underwent medical examinations at the Medical Care Center for Senile Dementia (MCCSD) of a local general hospital in Japan between September 1999 and March 2001. 133 of the patients suffered from dementia in Alzheimer's disease, 30 from vascular dementia, 12 from mixed dementia, and 28 from another type of dementia or psychiatric disorder, 131 of these individuals exhibited behavioral and psychological symptoms of dementia (BPSD), and 147 applied to the Long Term Care Insurance (LTCI) system which was introduced for residents aged 40 years or above. Most of the patients with a Clinical Dementia Rating (CDR) score of 3 were judged as having a high level of care need by the LTCI system, and those with a CDR score of I or less were also judged as having an adequate level of care need that corresponded to their decline in activities of daily life. The patients with a CDR score of 2 were, however, judged inadequately as having various levels of care need because their BPSD were undervaluated. This tendency was remarkable in the group of AD patients. Consequently, undervaluation of BPSD resulted in a discrepancy between the CDR score and the level of care need. The MCCSDs in the LTCI system are potentially able to play a definite role in providing sufficient care services for individuals with dementia. For adequate function of the LTCI system, it is necessary for the MCCSD to evaluate BPSD points correctly.
岐阜大学の論文
2004-03-31

介護保険制度下での老人性痴呆疾患センターの役割

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