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Review
Dementia and Neurocognitive Disorders 2012: 11: 2: 29-37

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일상생활능력과 치매
양영순·양현덕*·홍윤정†김정은‡·박문호§·나해리||한일우†·김상윤‡
보훈공단 중앙보훈병원 신경과 원광대학교 산본병원 신경과* 효자병원 신경과† 고려대학교 안산병원 신경과§ 보바스기념병원 신경과|| 서울대학교 의과대학 신경과학교실 & 분당서울대학교병원 신경과‡
Activities of Daily Living and Dementia
YoungSoon Yang, M.D., Hyun Duk Yang, M.D.*, Yun-Jung Hong, M.D.†, Jung Eun Kim, M.D.‡, Moon-Ho Park, M.D.§, Hae Ri Na, M.D.||, Il-Woo Han, M.D.†,SangYun Kim, M.D.‡
Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul; Department of Neurology*, Sanbon Medical Center, Wonkwang University, Gunpo; Department of Neurology†, Hoja Geriatric Hospital, Yongin; Department of Neurology§, Korea University College of Medicine, Ansan; Department of Neurology||, Bobath Memorial Hospital, Seongnam; Department of Neurology‡, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seongnam, Korea
Activities of daily living (ADL) refer to the ability to care for self and perform daily activities within an individual’s place or in outdoor environments. ADL comprise two main categories: Basic or physical ADL and Instrumental ADL. The latter allows for the earlier detection of functional decline than the former. The cognitive changes in neurodegenerative dementias contribute to the impaired ability of the patients to take care of themselves. Activities of daily living is a major criterion for diagnosing dementia. Furthermore, it has recently been emphasized that some impairment of activities of daily living, particularly of complex instrumental functions, is already present even in mild cognitive impairment prodromal stage of dementia, although mild cognitive impairment is distinguished from dementia by the absence of significant deficit in activities of daily living. The impaired activities of daily living increase the rate of institutionalization of the patients with dementia to nursing home and inevitably bring about the changes in the qualities of life not only of the patients but their caregivers. One of the best ways to evaluate the degree of impairment in activities of daily living and the care burden is through standardized functional assessment tools according to the severity of dementia. These tools provide objective data, thereby allowing the clinicians to judge decline and improvement in the functional status and to plan individualized care. In this review, we will review the clinical significance of evaluating ADL, the assessment tools according to the severity of dementia, and therapeutic approaches to enhance the functional levels. We will also review the impact of the impaired ADL on the quality of life among the patients and their care providers.
Key Words: Activities of daily living, Dementia, Caregiver
대한치매학회지 (Dementia and Neurocognitive Disorders)