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Introduction: The purpose of this study was to examine the effects of cognitive rehabilitation for depression, cognitive function, ADL, and QOL in patients with post-stroke depression (PSD). In addition, we evaluated the effects of cognitive rehabilitation on customer satisfaction with long-term care facilities and rehabilitation.Methods: This study included 8 participants with PSD who were residents of a long-term care facility located in Ibaraki Prefecture, Japan. In addition to their ordinary rehabilitation (2 sessions per week, 20 minutes per session), participants underwent 36 sessions of cognitive rehabilitation (3 sessions per week, 20 minutes per session, for 12 weeks). Primary outcome measures: Depression severity was measured using the Geriatric Depression Scale (GDS), Zung Self Depression Scale (SDS), and the Depression Scale of the Japan Stroke Scale (JSS-D). Frontal lobe function was assessed using the Frontal Assessment Battery (FAB). Secondary outcome measures: QOL was assessed using SF-8. Customer Satisfaction with the rehabilitation was measured using the Customer Satisfaction Scale based on Need Satisfaction (CSSNS). Assessments were performed before and after the rehabilitation.Results: The severity scores of depression, frontal lobe function, and customer satisfaction with the rehabilitation all significantly improved after the cognitive rehabilitation sessions.Conclusions: The results obtained in this trial indicate that, for patients with PSD depressive symptoms, frontal lobe function, QOL, and rehabilitation customer satisfaction may be improved by the inclusion of cognitive rehabilitation sessions alongside regular rehabilitation.
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Purpose: In this study, we performed a longitudinal examination of the occurrence of homeboundness among community-dwelling elderly individuals and changes in associated factors, including the sense of coherence (SOC).Methods: A questionnaire survey was conducted targeting community-dwelling elderly individuals to evaluate homebound status, a basic checklist (CL), and SOC. Among these individuals, frail elderly people who maintained a non-homebound state were extracted and a follow-up survey was carried out one year later. Those who maintained the non-homebound state one year later were classified into the maintenance group and those who became socially withdrawn were classified into the transition group. Factors predicting the homebound state one year later were examined using multiple logistic regression analysis. Furthermore, the changes in CL and SOC between the transition and maintenance groups were compared.Results: In the transition group, motor function, cognitive function, and sense of manageability on the initial survey were significantly lower than those in the maintenance group. Significant correlations were noted in the homebound transition group with lack of money management (OR: 3.04, 95% CI: 1.19-7.82) and a declined sense of manageability (OR: 0.82, 95% CI: 0.69-0.99). Depression and the sense of manageability had also significantly deteriorated one year later compared with those in the maintenance group.Conclusion: This study suggests that individuals who transition to a state of homeboundness have a slightly lower SOC than those who maintain their non-homebound status.
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<b>Purpose</b> : The purpose of the present study was to examine the relationship between respiratory function and ADL/QOL among community-dwelling elderly requiring support or care.<br><b>Methods</b> : The study included 87 elderly aged ≥65 years who were certified to require support (yousienn)or care (youkaigo)level 1-3 and who used day care at a rehabilitation center. We evaluated their respiratory, mental, physical, and swallowing functions. ADL, IADL, and QOL were estimated using a questionnaire. Spearman's rank correlation test and multiple regression analysis were used to examine correlations of the functions with ADL/QOL.<br><b>Results</b> : Respiratory, physical, and swallowing functions showed statistically significant correlations with ADL/IADL/QOL. Multiple regression analysis showed that forced expiratory volume in 1 second and swallowing function were related to ADL, IADL, and QOL (SF8body & mental).<br><b>Conclusion</b> : ADL and QOL were associated with respiratory function in elderly subjects requiring support or care. Our data suggested that pulmonary rehabilitation to enhance respiratory and swallowing functions in elderly requiring support or care may improve their ADL and QOL.
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<b>Purpose</b> : The purpose of this study was to examine quantitative activity and determine characteristics using an activity meter in community-dwelling frail elderly people.<br><b>Methods</b> : We monitored 25 community-dwelling elderly of support-requiring condition level1 and 2 by attaching activity monitoring evaluation system (A-MES) and measured physical activity (PA) over 24 hours as well as body information, care information, everyday life function.<br>We examined according to sex / care category using obtained results.<br><b>Results</b> : Women's standing position time and walk time were significantly longer, and men's daytime lying position and sitting position time were significantly longer.<br>Also, in persons of support-required condition level 2 there was a significantly higher number of posture changes from sitting position to daytime lying position.<br>It was suggested that a quantitative evaluation of the PA could lead to discovery of activity decrease in home life in association with each PA item and low rank criteria of the functional independence measure (FIM).<br>Securing of enough walk time and shortening of the lying position time in the daytime tend to be important for self-care ability and maintenance of locomotiveness.<br><b>Conclusion</b> : It was suggested that the evaluation of shortening the lying position time in the daytime and increasing the amount of position changes will supplement a decrease of the PA, which is related to preventing decrease in activity.