@article{oai:twinkle.repo.nii.ac.jp:00019149,
 author = {KAMO, Toshiko and HORIKAWA, Naoshi and TSURUTA, Yukio},
 issue = {2},
 journal = {東京女子医科大学雑誌},
 month = {Feb},
 note = {認知機能低下の原因検索のために,高齢維持血液透析患者33人における気分の状態,生活の質,日常生活の活動性,身体的状態,社会動態学的因子,脳磁気共鳴映像法所見の関与について調査した. Mini Mental States Examinationの平均得点は26.06±4.13点であり,対象の18%に痴呆の可能性が示唆された.脳MRIにおいて,脳血管障害に関連した異常所見は対象の81%に認められた. World Health Organization Quality of Life assessmentにおける自己評価は認知機能低下に影響を受けていなかったが,痴呆が疑われる群は,非痴呆群に比べ,統計学的に明らかにヘマトクリット値が低く, Profile of Mood States得点が高かった.判別分析を用いたところ,ヘマトクリット平均値は認知障害の第一の予測因子であった.我々の所見から,多くの高齢透析患者における認知障害は治療可能であることが示唆される.原因ないし増悪因子となりうる要因は,貧血,抑うつ患者の偽性痴呆,孤立的環境における反応性の低下である.認知機能障害への貧血の影響は若い患者よりも高齢患者においてより深刻であると考えられる.本研究から高齢外来継持血液透析患者における認知機能低下については,その原因検索と診断に対し,多次元的なアプローチ施行の重要性が提案される., In order to establish the etiology of cognitive impairment, this study examined the contribution of mood states, quality of life, activities of daily living, physical condition, sociodemographic factors, and brain magnetic resonance imaging (MRI) findings in 33 elderly regular hemodialysis outpatients. The patients' mean (±SD) Mini Mental States Examination score was 26.06 ± 4.13. Of the entire cohort, 18% could potentially be diagnosed with dementia. Abnormal features and vascular damage in particular, were observed in the brain MRI of 81% of our subjects. Self-evaluation using the World Health Organization Quality of Life assessment appeared to be unaffected by cognitive impairment. However, the group with suspected dementia exhibited a significantly lower hematocrit and a significantly higher Profile of Mood States score than the non-dementia group. With the aid of discriminant function analysis, the mean hematocrit value was identified as the best predictor variables for cognitive impairment. Our findings suggest that the etiology of cognitive impairment in a lot of elderly hemodialysis patient is treatable. The most likely causative or aggravating factors appear to be anemia, pseudodementia of depressive patients, and decreased reactivity in an isolated environment. In addition, it may be that the influence of anemia on cognitive dysfunction is more serious in elderly patients than in the younger population. We propose that it is very important to impose a multidimensional approach on the diagnosis of the etiology of cognitive impairment.},
 pages = {85--93},
 title = {Cross-sectional Evaluation of Cognitive Impairment in Elderly Regular Hemodialysis Outpatients : A Preliminary Study},
 volume = {74},
 year = {2004}
}