㧟㧚㜞ፒᏒߦ߅ߌࠆ⹺⍮ᯏ⢻ૐਅߩᛥ೙ലᨐߦ㑐ߔࠆ⎇ⓥႎ๔ᦠ                   ⟲㚍ᄢቇකቇㇱ଻ஜቇ⑼ጊญ᥍଻⎇ⓥቶ          㜞ፒᏒ 㐳ኼ␠ળ⺖‫ޤ⊛⋡ޣ‬㜞㦂ൻ␠ળߩㅴዷߦ઻޿⹺⍮∝ߩ੍㒐ᴺ⏕┙ߪ㊀ⷐᕈࠍჇߒߡ޿ࠆ‫⹺ޕ‬⍮∝ߪ⊒∝ߒߡ޿ߥ޿߇ቴⷰ⊛ߥ⹺⍮ᯏ⢻ૐਅࠍ␜ߔシᐲ⹺⍮㓚ኂ mild cognitive impairment: MCI ‫ࠃ߅ޔ‬߮⹺⍮ᯏ⢻ૐਅࠍ⥄ⷡߒߡ޿ࠆ߇ቴⷰ⊛⹺⍮ᯏ⢻ૐਅࠍᰳߊ⠪ subjective memory
complaints: SMC ߪ‫⹺ޔ‬⍮∝߳ߩ⒖ⴕ࡝ࠬࠢߩ㜞޿ߎߣ߇వⴕ⎇ⓥߦࠃࠅ␜ߐࠇߡ޿ࠆ‫ޕ‬ㄭᐕ‫⚛㉄᦭ޔ‬ㆇേ╬ߩり૕ᵴേߦࠃࠆ⹺⍮ᯏ⢻ᡷༀലᨐ߇ᵈ⋡ߐࠇ‫⹺ޔ‬⍮∝ᖚ⠪ߩ⹺⍮ᯏ⢻ᡷༀലᨐ‫ޔ‬/%+㜞㦂⠪ߩ᦭㉄⚛ㆇേߦࠃࠆ⹺⍮ᯏ⢻ᡷༀലᨐࠍ␜ߔRandomized
Controlled Trial RCT ੺౉⎇ⓥ߇ႎ๔ߐࠇߡ޿ࠆ‫੹ߢߎߘޕ‬࿁‫⹺ޔ‬⍮∝⟕ᖚ࡝ࠬࠢߩ㜞޿ߣߐࠇࠆ‫ޔ‬SMCࠍኻ⽎ߣߒ‫⹺ޔ‬⍮ᯏ⢻ૐਅ੍㒐ലᨐߩࠛࡆ࠺ࡦࠬࠍ␜ߔߎߣࠍ⋡⊛ߣߒߡ‫ޔ‬
RCTᴺ࠺ࠩࠗࡦߢߩ੺౉⎇ⓥࠍⴕߞߚ‫ޕ‬ㆇേߘߩ߽ߩ߽ലᨐ߇޽ࠆ߇‫ޔ‬ᭉߒ޿ㆇേߪࠃࠅ㜞޿ലᨐߩ޽ࠆߎߣ߇േ‛ታ㛎ߦࠃࠅ␜ߐࠇ‫␠ߚ߹ޔ‬ળᵴേߩ㜞޿⟲ߢߪ⹺⍮∝ߩ࡝ࠬࠢ߇ૐ޿ߣߩႎ๔߽޽ࠆߎߣ߆ࠄ‫ޔ‬ታᣉߦ޽ߚߞߡߪ‫ޔ‬㓸࿅ߩᵴᕈൻࠍᵴ↪ߒ‫ޔ‬ᭉߒߊෳടߢ߈ࠆࠃ߁ߦ㈩ᘦࠍߒߚ‫ޕ‬‫ޣ‬ᣇᴺ‫ޤ‬㧝㧚⎇ⓥኻ⽎⠪ߩ᛽಴ᧄ⎇ⓥߩኻ⽎⠪ࠍએਅߩᣇᴺߢ൐㓸ߒߚ‫ ޕ‬㧝㧕㜞ፒᏒ࿷૑ߢ‫ޔ‬ታᣉ࿾ၞ߆ᚲ㧔⍫ਛ࿾඙๟ㄝ‫ޔ‬ਛᎹ࿾඙๟ㄝ‫⟲ޔ‬㚍࿾඙‫ޔ‬ศ੗࿾඙๟ㄝ㧕ߦ࿷૑ߩᱦ߆ࠄᱦ߹ߢߩ㜞㦂⠪ߢ‫ޔ‬ᐔᚑᐕᐲታᣉߩ↢ᵴᯏ⢻⹏ଔࠍฃߌߚ߽ߩ‫ޕ‬ᐔᚑᐕ᦬ᣣߦ⍫ਛ㧦ㅢ‫ޔ‬ਛᎹ㧦ㅢ‫⟲ޔ‬㚍㧦ㅢ‫ޔ‬ศ੗㧦ㅢ‫ޔ‬ว⸘ㅢߩ‫ޟ‬㜞ፒᏒ߭ࠄ߼߈࠙ࠜ࡯ࠠࡦࠣᢎቶ‫ޠ‬੐ᬺ᩺ౝ࠴࡜ࠪࠍ৻ᢧߦㇷㅍߒߚ‫ߒ↳ߡߒߘޕ‬ㄟߺߩ޽ߞߚฬߦ⺑᣿ળߩ᩺ౝ⁁ࠍㅍઃߒߚ‫ޕ‬㧞㧕㐳ኼ࠮ࡦ࠲࡯೑↪⠪ฬ߇ෳടࠍᏗᦸߒߚ‫ޕ‬㧞㧚⺑᣿ળߩታᣉߣ⎇ⓥදജߩหᗧ⏕⹺⺑᣿ળ⺑᣿ળߩታᣉߣ⎇ⓥදജߩหᗧ⏕⹺⺑᣿ળෳട⠪ฬߦ‫ޔ‬㜞ፒᏒ⹺⍮∝੍㒐ࡊࡠࠫࠚࠢ࠻‫ޟ‬㜞ፒᏒ߭ࠄ߼߈࠙ࠜ࡯ࠠࡦࠣᢎቶ‫⿰ߩޠ‬ᣦ⺑᣿ࠍⴕ޿‫ޔ‬ฬ߆ࠄหᗧࠍᓧߚ㧔ฬ߇ㄉㅌ㧕‫ޕ‬ߘߩᓟ࿾඙ߢ࿁⋡ߩ⹏ଔࠍⴕ޿‫ޔ‬කᏧ㕙ធߢ⹺⍮∝ߣ್ᢿߐࠇߚฬ CDR㧕‫ޔ‬ᐕ㦂߇ᱦએ਄ߩฬ‫ࠆߔ᦭ࠍ∛∔ޔ‬⠪ฬߩ⸘ฬࠍ⎇ⓥኻ⽎߆ࠄ㒰޿ߚ‫ߦ⊛⚳ᦨޕ‬ฬࠍή૞ὑߦ

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13:41:37੺౉⟲ฬ‫ޔ‬ኻᾖ⟲ฬߦഀࠅઃߌߚ‫⎇ޕ‬ⓥኻ⽎⠪ߩዻᕈߪ⴫ߩߣ߅ࠅߢ޽ࠆ‫ޕ‬ᐔဋᐕ㦂߇ᱦ㧔SD㧕‫↵ޔ‬ᕈ߇㧑‫ޔ‬ᐔဋᢎ⢒ᐕᢙߪᐕ㧔SD㧕ߢ޽ߞߚ‫߹ޕ‬ߚ‫ޔ‬MMSE ߩᐔဋᓧὐߪὐ㧔SD㧕‫ޔ‬MMSE ߩᓧὐ▸࿐ߪὐ߆ࠄὐ‫ޔ‬CDRߩ⹏ଔ߇ߢ޽ߞߚ⠪ߪฬ㧔㧕ߢ޽ߞߚ‫ޕ‬⴫㧝 ⎇ⓥኻ⽎⠪ߩዻᕈ㗄⋡ᐕ㦂ᕈ೎ᢎ⢒ᐕᢙ
//5'シᐲ⹺⍮㓚੺౉⟲ኻᾖ⟲ో૕P P P  ᱦ ᱦᱦ

5&

5& 5& ↵ᕈฬ

↵ᕈฬ ↵ᕈฬ

ᅚᕈฬᅚᕈฬ

ᅚᕈฬ

ᐕ

ᐕ

ᐕ

5&㧩

5& 5& ὐὐὐ

5&

5& 5& ฬฬฬ㧔㧕㧔 

ኂ %&4  㧔㧕㧟㧚੺౉ࡊࡠࠣ࡜ࡓߩౝኈ੺౉⟲ߦߪ‫ޔ‬ㆇേ⠌ᘠߩ₪ᓧࠍ⋡ᮡߣߒߡ‫ޔ‬ㅳ࿁ಽߩ࠙ࠜ࡯ࠠࡦࠣࡊࡠࠣ࡜ࡓࠍో࿁㧔⚂߆᦬㧕ታᣉߒߚ‫ߪ౉੺ޕ‬㜞ፒᏒߩᆔ⸤ࠍฃߌߚ੐ᬺ⠪ ක≮ᯏ㑐࡮੺⼔଻㒾੐ᬺ⠪ߦዻߔࠆஜᐽㆇേᜰዉ჻╬߇ᜂᒰߒߚ‫੹ޕ‬࿁ߩ੺౉ߢߪ‫ޔ‬ෳട⠪ߩਥ૕ᕈ࡮ᗧ᰼ߩ㊀ⷞ‫߅ޔ‬ࠃ߮ࠣ࡞࡯ࡊߢߩ⋧੕૞↪ߦࠃࠆലᨐࠍ㊀ⷞߒߚ‫౉੺ޔ߼ߚߩߘޕ‬ᜂᒰ⠪ࠍෳട⠪ߩេഥࠍߔࠆࡈࠔࠪ࡝࠹࡯࠲࡯ߣ૏⟎ߠߌ‫ޔ‬੐೨ߦ੺౉⿰ᣦߩᔀᐩߣ੺౉ᣇᴺߩ⻠⠌ࠍⴕ޿‫ᦼ౉੺ޔ‬㑆ਛ߽‫ޔ‬㜞ፒᏒ࡮⟲㚍ᄢቇߣ੺౉ᜂᒰ⠪ߣߩᖱႎ੤឵ߦࠃࠅ‫⿰౉੺ޔ‬ᣦߦᴪߞߡታᣉߐࠇߡ޿ࠆ߆ߩ⏕⹺ࠍⴕߞߚ‫ޕ‬ߥ߅‫ࡓ࡜ࠣࡠࡊߩ߳⟲౉੺ޔ‬ታᣉᦼ㑆ਛ‫ޔ‬ኻᾖ⟲ߦߪ‫⎇ޔ‬ⓥදജߦኻߔࠆേᯏߠߌࠍ⛽ᜬߔࠆߚ߼ߦஜᐽ⻠⹤ળࠍ࿁ታᣉߔࠆߣߣ߽ߦ‫ޔ‬RCT⚳ੌᓟߦหߓ੺౉ࡊࡠࠣ࡜ࡓࠍታᣉߒ‫ޔ‬ෳട⠪ߩᐔ╬ߦ㈩ᘦߒߚ‫ޕ‬㧠㧚⹏ଔ㗄⋡੺౉ߩലᨐࠍ⹏ଔߔࠆߚ߼ߦ‫⋥౉੺ޔ‬ធലᨐߩ⹏ଔߣߒߡ↢ᵴᱠᢙ‫⹏ࡓࠞ࠻࠙ࠕޔ‬ଔߣߒߡਅ⸥ߩ⹏ଔࠍ᷹ቯߒߚ‫⚿ޕ‬ᨐ⹏ଔߩ⹏ଔ㗄⋡ߪ‫౉੺ࡓ࡜ࠣࡠࡊޔ‬೨㧔੐೨⹏ଔ㧕ߣ੺౉ᓟ－78－

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13:41:38㧔੐ᓟ⹏ଔ㧕ߩ࿁᷹ቯߒߚ㧔⴫㧕‫ޕ‬⴫ ⹏ଔ㗄⋡৻ⷩ⹏ଔ⒳೎

⹏ଔ㗄⋡੐೨⹏ଔ੐ᓟ⹏ଔ㧔1࿁⋡㧕 㧔࿁⋡㧕ࠕࡦࠤ࡯࠻⺞ᩏ∔∛ʊ㧔⥄⸥ᑼ㧕᦯⮎ʊ߽ߩᔓࠇʊ٤ኻੱ੤ᵹʊ٤ቇᱧʊෳട⋡⊛ʊஜᐽ⁁ᘒʊᕈᩰʊ⠧⎇ᑼᵴേ⢻ജᜰᮡʊ٤I-ADL‫ޔ‬ADLʊ٤ᣣᧄ⺆ࠛࡊࡢ࡯ࠬ⌁᳇ዤᐲʊ٤Lubben␠ળࡀ࠶࠻ࡢ࡯ࠢᜰᮡʊ٤↢ᵴⓨ㑆⹏ଔ㧔LSA㧕ʊ٤

QOL(ᣣᏱ↢ᵴḩ⿷ᐲ:SDL㧕ʊ٤߁ߟ௑ะ㧔GDS㧕ʊ٤␠ળᡰេࠬࠤ࡯࡞ʊ٤

MMSEʊ



CDRʊ

ࡈࠔࠗࡉ࡮ࠦࠣᬌᩏ*ʊ٤WAIS-Υ ╓ภ໧㗴ʊ٤ጊญ╓ภ࠹ࠬ࠻**ʊ٤TMT-A㧒Bʊ٤

Stroop࠹ࠬ࠻ʊTimed Up&Goʊ٤5㨙ㅢᏱᱠⴕᤨ㑆ʊ

٤5㨙ᦨᄢᱠⴕᤨ㑆ʊ٤⹺⍮࠹ࠬ࠻ㆇേᯏ⢻ᬌᩏࡈࠔࠗࡉࠦࠣᬌᩏߪ‫ޔ‬ਗⴕ⺖㗴 ਗⴕಣℂ⢻ജ ‫ޔ‬ౣ↢⺖㗴 ㆃᑧౣ↢⢻ജ ‫⸘ᤨޔ‬ឬ↹ ⷞⓨ㑆⹺⍮⢻ജ࡮ታⴕᯏ⢻ ‫⺖⺆⸒ޔ‬㗴 ⸒⺆ᵹᥰᕈᯏ⢻ ‫ޔ‬㘃ૃ⺖㗴 㘃ផᯏ⢻ ߩਅ૏ᬌᩏ߆ࠄߥࠆ‫ޕ‬ጊญ᥍଻⎇ⓥቶߩ HP
JVVRQTCJQQEQO[COCIWEJKJࠃࠅήᢱ࠳࠙ࡦࡠ࡯࠼

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13:41:38㧡㧚ಽᨆᣇᴺ⎇ⓥኻ⽎⠪ฬߩ߁ߜ‫ߪ⟲౉੺ޔ‬ฬ߇ㄉㅌߒฬߣߥߞߚ‫ߦࠄߐޕ‬ฬ߇࿁ߢ⣕⪭‫ޔ‬ฬ߇੐ᓟ⹏ଔ㧔╙࿁㧕ࠍᰳᏨ‫ޔ‬ฬ߇࿁ߩࡊࡠࠣ࡜ࡓߦ࿁એਅߩෳടߢಽᨆኻ⽎ᄖߣߒߚ⚿ᨐ‫ߪ⟲౉੺ޔ‬ฬߣߥߞߚ‫ޕ‬ኻᾖ⟲ฬߪ‫ޔ‬੐ᓟ⹏ଔ㧔╙࿁㧕ࠍฬ߇ᰳᏨߒ‫ޔ‬ฬߣߥߞߚ‫ޕ‬ᓥߞߡ‫⸃ޔ‬ᨆߩኻ⽎ߪว⸘ฬߣߥߞߚ㧔⾗ᢱෳᾖ㧕‫ޕ‬ಽᨆߪ‫ޔ‬੐೨࡮੐ᓟߩฦ⹏ଔ㗄⋡ࠍᓥዻᄌᢙߣߒߚ‫ᦼ⟲ޔ‬㑆ߩⷐ࿃ಽᢔಽᨆ㧔repeatedmeasured ANCOVA㧕ࠍⴕߞߚ‫౒ޕ‬ᄌ㊂ߦߪ‫ޔ‬ᐕ㦂‫ޔ‬ᕈ೎‫ޔ‬ᢎ⢒ᐕᢙࠍᛩ౉ߒߚ‫ޕ‬‫⁁౉੺ޣ‬ᴫ‫ߩࡓ࡜ࠣࡠࡊ౉੺ޤ‬಴Ꮸ₸ࡊࡠࠣ࡜ࡓߦߪ‫⟲౉੺ޔ‬ฬߩ߁ߜฬ߇ෳടߒߚ‫ޕ‬࿁ߢෳടࠍਛᢿߒߚ଀ࠍ㒰ߊߣ‫ޔ‬ో࿁ߩࡊࡠࠣ࡜ࡓߩ಴Ꮸ₸ߪᐔဋ㧑ߣ㕖Ᏹߦ⦟ᅢߢ޽ߞߚ‫ޕ‬࿾඙ߏߣߩෳട₸ߪ‫ޔ‬⍫ਛ㧑‫ޔ‬ਛᎹ㧑‫⟲ޔ‬㚍㧑‫ޔ‬ศ੗㧑ߢ޽ߞߚ‫ޕ‬‫⚿ޣ‬ᨐ‫ޤ‬㧝㧚੺౉⋥ធലᨐߩ⹏ଔ㧦↢ᵴᱠᢙჇടലᨐ੺౉ߩ೨ᓟߢㅳ㑆‫ޔ‬ᱠᢙߩ⷗߃ߥ޿⋡㓝ߒਁᱠ⸘ࠍⵝ⌕ߒߡᲧセߒߚ‫⚿ߩߘޕ‬ᨐ‫⟲౉੺ޔ‬ߢߪኻᾖ⟲ߦᲧߴߡᱠᢙ߇᦭ᗧߦ਄᣹ߒߡ޿ߚ㧔R㧧੺౉⟲ ੺౉೨rᱠ ੺౉ᓟrᱠ‫ޔ‬㕖੺౉⟲ ੺౉೨rᱠ ੺౉ᓟrᱠ㧕‫ޕ‬࿑ ోኻ⽎⠪ߢߩ↢ᵴᱠᢙߩᄌൻ੺౉⟲ߢ᦭ᗧߦჇടߒߚ



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13:41:39㧞㧚੺౉ࠕ࠙࠻ࡊ࠶࠻⹏ଔ A. ⹺⍮ᯏ⢻߳ߩലᨐ㧝㧕ోኻ⽎⠪㧔n㧕ߢಽᨆࠍⴕߞߚߣߎࠈ‫⹺ޔ‬⍮ᬌᩏߢߪࡈࠔࠗࡉࠦࠣߩ⸒⺆ᵹᥰᕈ⺖㗴ߦ߅޿ߡ‫᦭ޔ‬ᗧߥ੺౉ലᨐ߇ߺࠄࠇ‫ޔ‬ኻᾖ⟲ࠃࠅ߽੺౉⟲ߩᣇ߇ࠃࠅᚑ❣߇ࠃߊߥߞߚߎߣ߇␜ߐࠇߚ㧔੤੕૞↪F  p㧧࿑ෳᾖ㧕‫᦭ߩߎޔ߅ߥޕ‬ᗧᏅߪஜᏱ⟲ CDR0 ߩߺߢ߽଻ߚࠇߡ޿ࠆ߇ F  p ‫ޔ‬MCI⟲ߩߺߢߪ᦭ᗧᏅ
ߪߺࠄࠇߥ߆ߞߚ㧔F 㧕p ‫ޕ‬࿑ ోኻ⽎⠪ߢߩ⸒⺆ᵹᥰᕈ

੺౉⟲ߢ᦭ᗧߦᡷༀߒߚ












－81－

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13:41:39㧞㧕シᐲ⹺⍮㓚ኂ㧔MCICDR㧕⟲ߢߩಽᨆߢߪ‫ޔ‬ታⴕᯏ⢻ࠍ್ቯߔࠆTMT-B㧔F  p࿑ෳᾖ㧕‫߮ࠃ߅ޔ‬೨㗡⪲࡮ᵈᗧᯏ⢻ࠍ್ቯߔࠆጊญ╓ภ࠹ࠬ࠻ߢ᦭ᗧߥᡷༀࠍ⹺߼ߚ㧔F   p࿑ෳᾖ㧕‫ޕ‬

࿑ MCI⟲ߢߩTMT-B ጊญ╓ภ࠹ࠬ࠻ᚑ❣MCI⟲ߢ᦭ᗧߦᡷༀߒߚ     

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13:41:39

B㧚↢ᵴᯏ⢻߳ߩലᨐ ↢ᵴᯏ⢻ߩ⹏ଔዤᐲߣߒߡߩ⠧⎇ᑼᵴേ⢻ജᜰᮡߪ‫ోޔ‬ኻ⽎⠪ߢ᦭ᗧߥ੺౉ലᨐ߇ߺࠄࠇ
F  p㧧࿑ෳᾖ ‫᦭ޔ‬ᗧᏅߪஜᏱ⟲ F  p ߩߺ‫ޔ‬߅ࠃ߮MCI⟲ F  p ߩߺߢ߽ߺࠄࠇߚ‫ޕ‬ ࿑ ోኻ⽎⠪ߢߩ⠧⎇ᑼᵴേ⢻ജᜰᮡ੺౉⟲ߢ᦭ᗧߦᡷༀߒߚ












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C㧚ᔃℂ㕙ߢߩലᨐ ⥄⸥ᑼ5&.⺞ᩏ␿ߢQOLࠍ᷹ቯߒߚߣߎࠈ‫ోޔ‬ኻ⽎⠪ߢ᦭ᗧߥ੺౉ലᨐ߇ߺࠄࠇߚ
㧔F  㧩p㧧࿑ෳᾖ㧕‫ߩߎޕ‬ᏅߪஜᏱ⟲ߩߺ F   p ‫ޔ‬MCI⟲ߩߺ F  p ߢ߽଻ߚࠇߡ޿ࠆ‫ޔ߅ߥޕ‬MCI⟲ߩߺߢߪ߁ߟ௑ะ
㧔GDS㧕ߦ߽੺౉ലᨐ߇ߺࠄࠇߚ㧔F  p࿑ෳᾖ㧕‫ޕ‬࿑ ోኻ⽎⠪ߢߩQOL੺౉⟲ߢQOL߇ᡷༀߒߚ㧔ὐᢙૐਅ߇ᡷༀ㧕࿑ MCI⟲ߢߩ߁ߟ௑ะ㧔GDS㧕੺౉⟲ߢ߁ߟ௑ะ߇シᷫߒߚ


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D㧚ㆇേᯏ⢻߳ߩലᨐ૕ജ㕙ߢߪTimed Up&Goߢోኻ⽎⠪ߢ᦭ᗧߥ੺౉ലᨐ߇ߺࠄࠇߚ F  p࿑ෳᾖฬ߇૕ജᬌᩏࠍ᫈ᮭ ‫ޕ‬ஜᏱ⟲ߩߺߢ߽᦭ᗧᏅߪ଻ߚࠇࠆ߇
F  p ‫ޔ‬MCI⟲ߩߺߢߪ᦭ᗧ௑ะߣߥߞߚ㧔F  p㧕‫ޕ‬࿑ Timed Up&Go࠹ࠬ࠻੺౉⟲ߢㆇേᯏ⢻߇ᡷༀߒߚ㧟㧚⸒⺆ᵹᥰᕈ⺖㗴ߢ੺౉ലᨐࠍ␜ߒߚෳട⠪ߩⷐ࿃ಽᨆ⸒⺆ᵹᥰᕈ⺖㗴ߢലᨐߩ಴ߚෳട⠪ߩ੺౉೨ೋᦼ⁁ᘒߩⷐ࿃ࠍᬌ⸛ߒߚ‫౉੺ޕ‬೨ߩ␠ળᕈߩⷐ࿃ߩᐔဋ㧗SD߆ࠄᐔဋ㧗SD߹ߢࠍ㜞⟲‫ޔ‬ᐔဋ́SD߆ࠄᐔဋ́SD߹ߢࠍૐ⟲ߣߒ‫ޔ‬⸒⺆ᵹᥰᕈߩ⚿ᨐߩ⟲㑆Ყセࠍⴕߞߚ‫␠ޕ‬ળᕈߩⷐ࿃ߣߒߡߪ‫␠ޔ‬ળࡀ࠶࠻ࡢ࡯ࠢᜰᮡ㧔Lubben㧕ߦࠃࠅኅᣖⷫᣖ࡮੤෹㑐ଥߩ␠ળࡀ࠶࠻ࡢ࡯ࠢߩᄢ߈ߐ‫␠ޔ‬ળᡰេࠬࠤ࡯࡞ߦࠃࠅኅᣖⷫᣖ࡮੤෹㑐ଥߦ߅ߌࠆ࠰࡯ࠪࡖ࡞ࠨࡐ࡯࠻ࠍឭଏ࡮ฃ㗔ߩਔ㕙ߦಽߌߡᬌ⸛ߒߚ‫ޕ‬ߐࠄߦ‫ޔ‬୘ੱⷐ࿃ߣߒߡ୘ੱߩ․ᕈࠍᄖะᕈ࡮␹⚻∝⊛௑ะ㧔ౝะᕈ㧕࡮㐿᡼ᕈ࡮⺈ታᕈ࡮ද⺞ᕈߩ㧡㕙߆ࠄᬌ⸛ߔࠆBigࠍ↪޿ߡห᭽ߩಽᨆࠍⴕߞߚ‫ޕ‬ ߘߩ⚿ᨐ‫␠ޔ‬ળࡀ࠶࠻ࡢ࡯ࠢ࡮␠ળᡰេࠬࠤ࡯࡞ਔ⠪ߦ߅޿ߡኅᣖⷫᣖ࡮੤෹㑐ଥ‫ޔ‬෸߮ࠨࡐ࡯࠻ឭଏ࡮ฃ㗔㑐ଥߣ߽ߦૐ⟲ߦ᦭ᗧߥ⸒⺆ᵹᥰᕈߩᡷༀലᨐ߇␜ߐࠇߚ‫ޕ‬୘ੱⷐ࿃ߣߒߡߪ‫ޔ‬ᄖะᕈߩૐ⟲෸߮␹⚻∝⊛௑ะ㧔ౝะᕈ㧕㜞⟲ߦ᦭ᗧߥᡷༀലᨐ߇⷗ࠄࠇ‫ઁߩߘޔ‬ߩⷐ࿃ߢߪ‫ޔ‬㐿᡼ᕈ࡮⺈ታᕈߩૐ⟲‫ޔ‬ද⺞ᕈ㜞⟲ߦᡷༀലᨐ߇⷗ࠄࠇߚ‫ޕ‬ ߎߩ⚿ᨐߦࠃࠅ‫ޔ‬㐽ߓߎ߽ࠅ௑ะߩෳട⠪߇‫ޔ‬㓸࿅ᵴേߦෳടߔࠆߎߣߢ⸒⺆ᵹᥰᕈߩᡷༀലᨐ߇ᦼᓙߐࠇࠆ‫ޕ‬

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13:41:40‫ޤ߼ߣ߹ޣ‬ಽᨆߩ⚿ᨐ‫⎇ޔ‬ⓥኻ⽎⠪ో૕ߢߪ‫౉੺ࠆࠃߦࡓ࡜ࠣࡠࡊࠣࡦࠠ࡯ࠜ࠙ߩ᦬߆ޔ‬ലᨐߪ‫ޔ‬Ԙ⹺⍮࠹ࠬ࠻ߢߪࡈࠔࠗࡉࠦࠣߩ⸒⺆ᵹᥰᕈ⺖㗴‫ޔ‬ԙ↢ᵴᯏ⢻ߢߪ⠧⎇ᑼᵴേ⢻ജᜰᮡ‫ޔ‬Ԛᔃℂ㕙ߢߪQOL‫ޔ‬ԛㆇേᯏ⢻ߢߪTimed Up&Goߢߣ‫ޔ‬᏷ᐢ޿੺౉ലᨐ߇⛔⸘ቇ⊛᦭ᗧᏅࠍᜬߞߡ␜ߐࠇߚ‫ޕ‬ߐࠄߦ‫ޔ‬シᐲ⹺⍮㓚ኂ㧔MCI;CDR㧕⟲න⁛ߢߪ‫ޔ‬਄⸥ߩԙԚߦട߃‫ޔ‬Ԝ⹺⍮ᯏ⢻ߣߒ
ߡTMT-B‫ޔ‬ጊญ╓ภ࠹ࠬ࠻ߣԝᔃℂ㕙ߢߪQOLߣ߁ߟ௑ะࠍ᷹ቯߔࠆGDSߢߩ᦭ᗧߥᡷༀലᨐ߇␜ߐࠇߚ‫⚿ߩߎޕ‬ᨐߪ‫⎇ᧄޔ‬ⓥߢታᣉߒߚ࠙ࠜ࡯ࠠࡦࠣࡊࡠࠣ࡜ࡓ߇‫⹺ޔ‬⍮ᯏ⢻ߩ߿߿ૐਅߒߚ․ቯ㜞㦂⠪ะߌߩࡊࡠࠣ࡜ࡓߣߒߡലᨐ⊛ߢ޽ࠆߎߣࠍ␜ߒߡ޿ࠆ‫ޕ‬ࡊࡠࠣ࡜ࡓߩ಴Ꮸ₸߇㜞߆ߞߚߎߣ߿੺౉⟲ߩ↢ᵴᱠᢙ߇᦭ᗧߦჇടߒߚߎߣࠍ⠨߃ࠆߣ‫ޔ‬ᧄ⎇ⓥߢታᣉߒߚ੺౉ࡊࡠࠣ࡜ࡓߪ‫ޔ‬࿾ၞ㜞㦂⠪ߩ࠙ࠜ࡯ࠠࡦࠣߩ⠌ᘠൻࠍᡰេߔࠆࡊࡠࠣ࡜ࡓߣߒߡ‫ޔ‬ᅷᒰᕈ߇㜞ߊ‫ޔ‬㜞㦂⠪ߦߣߞߡ߽ขࠅ⚵ߺ߿ߔ޿ౝኈߢ޽ߞߚߣᕁࠊࠇࠆ‫ޕ‬ᒁ߈⛯߈‫⥄ޔ‬ਥᵴേߩෳട₸߿↢ᵴᱠᢙߩᄌൻࠍㅊ〔⺞ᩏߒ‫ޔ‬㐳ᦼߦ࠙ࠜ࡯ࠠࡦࠣ⠌ᘠ߇ቯ⌕ߒߡ޿ࠆ߆ߤ߁߆ࠍᬌ⸽ߒߡ޿ߊᔅⷐ߇޽ࠆߛࠈ߁‫ޕ‬⃻ⴕߩ․ቯ㜞㦂⠪ࠍኻ⽎ߦߒߚ੺⼔੍㒐੐ᬺߢߪ‫߇᦬߆ޔ‬ᮡḰ⊛ߥ੺౉ᦼ㑆ߣߥߞߡ޿ࠆߩߢ‫⎇ᧄޔ‬ⓥߢ߽߆᦬ߩ੺౉ᦼ㑆ࠍ⸳ቯߒߚ߇‫ޔ‬᏷ᐢ޿੺౉ലᨐࠍ␜ߔߎߣ߇ߢ߈ߚ‫ޕ‬‫ޣ‬㜞ፒᏒߩ᧪ᐕᐲߩ੐ᬺዷ㐿‫ޤ‬㜞ፒᏒߢߪ੹ᐕᐲߩ⚿ᨐࠍฃߌ‫᧪ޔ‬ᐕᐲࠃࠅ⥄ᴦ૕߇ᆔ⸤੐ᬺߣߒߡ⹺⍮ᯏ⢻ૐਅ੍㒐੺౉ࠍⴕ߁ࡕ࠺࡞ߩ૞ᚑߦ⌕ᚻߔࠆ‫੹ߪࡓ࡜ࠣࡠࡊ౉੺ޕ‬ᐕᐲߣหߓ࠙ࠜ࡯ࠠࡦࠣߩ⠌ᘠൻࠍ⋡⊛ߣߒ‫ޔ‬ታᣉߦ޽ߚߞߡߪෳട⠪ߩਥ૕ᕈࠍ㊀ⷞߒᗧ᰼ࠍᒁ߈಴ߒ‫ޔ‬㓸࿅ߦࠃࠆലᨐࠍᵴ↪ߔࠆߎߣߦ⇐ᗧߔࠆ‫ޕ‬੺౉ߦ޽ߚߞߡߪ‫ޔ‬੐೨ߦ੺౉ᜂᒰ⠪ߦ⟲㚍ᄢቇ࡮㜞ፒᏒߦࠃࠆ⻠⠌ࠍⴕ޿੺౉⿰ᣦߩᔀᐩࠍ࿑ࠅ‫౉੺ޔ‬೨ᓟߩ⹏ଔࠍ⛔৻ߔࠆߎߣߦࠃࠅ‫❑ޔ‬ᢿ⊛ലᨐࠍᬌ⸛ߔࠆ‫⥄ߩઁޔߦࠄߐޕ‬ᴦ૕ߦ߽ᵴ↪ߒߡ߽ࠄ߁ߎߣߦࠃࠅ‫ޔ‬ലᨐߩᮮᢿ⊛Ყセ߽น⢻ߣߥࠆ‫ޕ‬ෳട⠪୘ੱߦߪ‫ઁޔ‬ੱߣߩᲧセߢߪήߊ୘ੱ⚿ᨐߩᡷༀലᨐࠍࡈࠖ࡯࠼ࡃ࠶ࠢߔࠆߎߣߦࠃࠅ‫ޔ‬ㆇേ⠌ᘠ⛮⛯ࠍଦߔ‫ޕ‬߹ߚ‫⹺ޔ‬⍮ᯏ⢻ૐਅ੍㒐ߩขࠅ⚵ߺ߇࿾ၞߦᩮઃ޿ߡ޿ߊߚ߼ߦߪ‫ޔ‬Ꮢਥ૕ߩ⍴ᦼ㑆ߩᵴേ߆ࠄ࿾ၞߩ⥄ਥࠣ࡞࡯ࡊ߳ߩ⒖ⴕ࡮ቯ⌕߇㊀ⷐߥⷐ࿃ߣߥࠆ‫ᦼ౉੺ޔߡߞ߇ߚߒޕ‬㑆ਛߦෳട⠪߇⥄ਥࠣ࡞࡯ࡊߦ⒖ⴕߒ‫ߚ߹ޔ‬࿾ၞߢߩᣂߚߥขࠅ⚵ߺߩᄾᯏߣߥࠆࠃ߁㈩ᘦߒߡ޿ߊ‫ޕ‬

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13:41:41‫⎇ޣ‬ⓥ⾌‫ޤ‬ᧄ⎇ⓥߪ‫ޔ‬ෘ↢ഭ௛⋭ߩ੺⼔੍㒐ታᘒ⺞ᩏಽᨆᡰេ੐ᬺߣߒߡ㜞ፒᏒ߇ฃ⸤ߒߚ੺⼔੍㒐੐ᬺߢ‫ޔ‬㜞ፒᏒ⹺⍮∝੍㒐ࡊࡠࠫࠚࠢ࠻‫ޟ‬㜞ፒᏒ߭ࠄ߼߈࠙ࠜ࡯ࠠࡦࠣᢎቶ‫ࠇࠊⴕߡߒߣޠ‬ߚ‫ޕ‬‫ޣ‬ᜂᒰ⠪‫ޤ‬⟲㚍ᄢቇකቇㇱ଻ஜቇ⑼ጊญ⎇ⓥቶ  ጊญ᥍଻‫’ޔ‬㓁ሶ‫᧛ޔ‬੗㆐ᒾ‫ޔ‬ጊญᥓ᥍‫◉ޔ‬ේࠆߺ‫ޔ‬㜞੗ᕺℂሶ㜞ፒஜᐽ⑔␩ᄢቇ଻ஜක≮ቇㇱ↰ਛ⡡৻‫ޔ‬ጊ਄ᔀ਽ 㜞ፒᏒ㐳ኼ␠ળ⺖  ⍾⋄⟤᮸ᨑ‫ޔ‬ᶏ଻ ᱠ‫ޔ‬ᰞ੗ਃኈሶ‫ޔ‬૒‫ᧁޘ‬ᄐቄ‫ޣ‬ෳ⠨ᢥ₂‫ޤ‬
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8. Fratiglioni L, Wang HX, Ericsson K et al. Influence of social network on occurrence ofdementia: a community-based longitudinal study. Lancet 2000㧧355㧦1315-1319.

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13:41:41⾗ᢱ 㧦 ࿑ ⎇ⓥߩᵹࠇ－89－11-05-297.indd

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A  ⹺⍮࠹ࠬ࠻  FC     ࡈࠔࠗࡉࠦࠣ  WAIS-Υ  ࠙ࠚࠗࠬΥ╓ภ໧㗴YKSSTጊญ╓ภ࠹ࠬ࠻㧮 ⠧⎇ᑼ  ⠧⎇ᑼᵴേ⢻ജᜰᮡ㧯 ᔃℂ㕙ᬌᩏ㧰 ㆇേᯏ⢻TUG  Timed Up&Go
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13:41:41 ⴫  MCI ⟲ߢߩ⚿ᨐ৻ⷩ


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