高齢者の痴呆,日常生活動作および膀胱機能の検討 特別養護老人ホームにおける排尿管理―

Abstract

特別養護老人ホームの入寮者を対象に痴呆, ADLと排尿障害について調査した。ADLが低いほど, 痴呆度が高度なほど, 尿失禁の割合が増加した。排尿動態検査では, 49名中膀胱機能正常が25名, 過活動が16名, 低活動は8名であった。痴呆はないが尿失禁を認める者は, 膀胱機能の異常を認めた

This report shows the relation between daily activities, dementia and urinary disturbance. The subjects consisted of 44 males and 110 females with an average age of 80 years (ranged from 57 to 102). We evaluated the daily activities, underlying diseases, state of urination and the intelligence by the scale of Hasegawa. The persons with diapers had a higher degree of dementia than those who could go to the lavatory. As the degree of dementia aggravated, the incidence of urinary incontinence significantly increased. Urodynamic studies were performed on 49 persons who had urinary disturbance. There were 25 persons with normal vesical function, 16 with overactive vesical function, and 8 with underactive vesical function. Since all of the incontinent persons without dementia had abnormal vesical function, pharmacologic therapy was expected to be effective for them to improve incontinence. Half of the incontinent persons with dementia had normal vesical function. Mental and physical disabilities seemed to be the main factors causing incontinence in these persons. The multidisciplinary approach including medication, behavior treatment and awareness of the nursing staff is important and effective to reduce urinary incontinence.