老人性痴呆患者の尿失禁対策 : 痴呆と尿失禁と日常生活動作の関係について

Abstract

1)社会生活に支障をきたす程度の老人痴呆患者では日常生活動作の障害, 痴呆, 尿失禁の3者の重症度には相関関係が見られた.特に日常生活動作の障害程度が尿失禁に与える影響が特に大きい.2)老人性痴呆の尿失禁対策を行うことにより効果が期待できるのは自力でベットより移動できる日常生活動作の良好な症例である

The actual conditions of urinary incontinence in 101 patients with senile dementia (23 men and 78 women, average age 80 years) and their urinary control was studied. The three categories of 1) dementia severity, 2) activity of daily living and 3) degree of urinary incontinence, were each divided into five grades and the patients were evaluated accordingly. The correlation among the grades was studied. Of the 101 patients, 87 had urinary incontinence. These 87 were further subdivided into two groups: an ambulatory patient group (25) in which the patients could manage their own daily activity, and the bedridden group (62). The countermeasures for the first group of patients were, usage of a portable chamber pot for 6 patients and induced urination in 5. An anticholinergic agent was administered to 47 of the bedridden patients. The condition of urinary incontinence was reevaluated in both groups 4 weeks later. A high degree of correlation was observed among the grades of dementia severity, activity of daily living and urinary incontinence severity. After the countermeasures taken, improvement in urinary incontinence was observed in the 6 patients who used a portable chamber pot, and in the 5 patients who were subjected to induced urination. No improvement was seen in urinary incontinence in the bedridden patients who were treated with an anticholinergic agent. In conclusion, countermeasures for urinary incontinence in senile dementia should be indicated primarily for patients who can manage their own daily activity.