ความชุกของภาวะความทรงจำบกพร่องและปัจจัยที่เกี่ยวข้อง ในผู้สูงอายุ ชมรมผู้สูงอายุ
ความชุกของภาวะความทรงจำบกพร่องและปัจจัยที่เกี่ยวข้อง
คำสำคัญ:
ภาวะความทรงจำบกพร่อง, ผู้สูงอายุ, ปัจจัยเสี่ยงบทคัดย่อ
ครึ่งหนึ่งของผู้ที่มีภาวะความทรงจำบกพร่องสมองจะเสื่อมจนเป็นโรคอัลไซเมอร์ภายใน 5 ปี การวิจัยแบบวิเคราะห์ชนิดมีกลุ่ม เปรียบเทียบนี้มีวัตถุประสงค์เพื่อประเมินความชุกของภาวะความทรงจำบกพร่องและปัจจัยที่เกี่ยวข้องกับการเกิดภาวะความทรงจำ บกพร่องในผู้สูงอายุ โดยศึกษาในผู้สูงอายุที่เป็นสมาชิกชมรมผู้สูงอายุโรงพยาบาลพุทธชินราช พิษณุโลก 1 ปีขึ้นไป เข้าร่วม กิจกรรมกับชมรมอย่างต่อเนื่อง และไม่มีประวัติปัญหาจิตประสาทอย่างรุนแรงที่สมัครใจเข้าร่วมวิจัย ซึ่งมีจำนวน 155 คน เครื่องมือ ที่ใช้ในการวิจัย ได้แก่ แบบสอบถามข้อมูลส่วนบุคคลแบบสอบถามปัจจัยที่เกี่ยวข้อง และแบบทดสอบประเมินพุทธิปัญญา (MoCA) นำเสนอข้อมูลเป็นจำนวน ร้อยละค่าเฉลี่ย และค่าเบี่ยงเบนมาตรฐาน เปรียบเทียบข้อมูลระหว่างผู้สูงอายุที่มีภาวะความทรงจำ บกพร่องกับความทรงจำปกติด้วยสถิติ chi-square และ Fisher’s exact กำหนดระดับนัยสำคัญทางสถิติที่ 0.05 พบว่าความชุกของภาวะความทรงจำบกพร่องในผู้สูงอายุเท่ากับร้อยละ 47.1 โดยบกพร่องด้านการจดจำและการทวนความจำกับด้านมิติสัมพันธ์/ การบริหารจัดการมากกว่าด้านอื่น ปัจจัยที่เกี่ยวข้องอย่างมีนัยสำคัญทางสถิติกับการเกิดภาวะความทรงจำบกพร่อง ได้แก่ อายุ สถานภาพสมรส ระดับการศึกษา การประกอบอาชีพในปัจจุบัน การเจ็บป่วยด้วยโรคเรื้อรัง การใช้ยากลุ่ม anticholinergic การ จัดการความเครียดที่เหมาะสม และการสูบบุหรี่ จึงควรนำข้อมูลนี้ประกอบการพัฒนากิจกรรมชะลอภาวะความทรงจำบกพร่องที่ เหมาะสมแก่ผู้สูงอายุ รวมทั้งศึกษาติดตามผลของการจัดกิจกรรมชะลอภาวะความทรงจำบกพร่องอย่างต่อเนื่อง
References
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2. Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2017 [Internet]. 2019 [cited 2020 Nov 20]. Available from: URL: https:// thaitgri.org/?wpdmpro=situation-of-the-thaieldery-2019
3. Health Data Center, The Ministry of Public Health. Elderly population data 2016-2018 [Internet]. 2018 [cited 2020 Nov 20]. Available from: URL: https://hdcservice.moph. go.th/hdc/reports
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13. Elderly Club, Buddhachinaj Phitsanulok Hospital. Performance report of Elderly Club, 2017. Phitsanulok, Thailand: Elderly Club, Buddhachinaj Phitsanulok Hospital; 2018.
14. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695-99.
15. Hemranchroj S. Cognitive impairment in medicine basic and clinical neuroscience. MoCA Thai version. Bangkok, Thailand: Chulalongkorn University Printing House; 2010.
16. Tangwongchai S, Phanasathit M, Charernboon T, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The validity of Thai version of The Montreal Cognitive Assessment (MoCA-T). Dement Neuropsychol [online]. 2009 [cited 2020 Nov 10];3 (2):172. Available from: http://demneuropsy.com.br/imageBank/pdf/dnv03n02a11.pdf
17. Rattanawat W, Nakawiro D, Visajan P. Prevalence of mild cognitive impairment (MCI) in pre-retirement period of hospital staff. J Psychiatr Assoc Thai 2018;63(1):55-64.
18. Chaimay P. Caution in using chi-square test in health science research. Thaksin Univ J 2010;13(1):55-8.
19. Praison P, Chuajedton P. Factors related to mild cognitive impairments in elderly people in Chiang Rai Province. Thai J Nurs C 2017;32(1):64-78.
20. Saowaphan J, Suwan P, Thajang S, Phonchari P, Voharndate J. Prevalence of mild cognitive impairment in older people at semi-rural community, Udonthani Province. Documents for the 4th National Conference; 2019 May 31; Rajthanee University, Ubon Ratchathanee.
21. Undara W, Singhasenee U, Wongnitikul P. The study of dementia, knowledge and prevention of dementia and the demographic data in the Elderly Association of Royal Thai Air Force Nursing College. J Police Nurs 2016;8(1):23-33.
22. Saunders N, Summers M. Attention and working memory deficits in mild cognitive impairment [Internet]. 2010 [cited 2020 Nov 10]. Available from: URL: https://www. researchgate.net/publication/26854413_Attention_and_working_memory_ deficits_in_ mild_cognitive_impairment
23. World Health Organization. Dementia cases set to triple by 2050 but still largely ignored [Internet]. 2012 [cited 2020 Nov 20]. Available from: URL: https://www.who.int/mediacentre/news/releases/2012/dementia_20120411/en/
24. Petersen R, Lopez O, Armstrong M, Getchius T, Ganguli M, Gloss D, et al. Practice guideline update summary: mild cognitive impairment. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90 (3):126-35.
25. Yodmai K. Family role and caring an aging with dementia in community. J Public Health Nurs 2017;31(1):189-204.
26. Brenowitz W, Kukull W, Beresford S, Monsell S, Williams E. Social relationships and risk of incident mild cognitive impairment in U.S. Alzheimer's Disease Centers. Alzheimer Dis Assoc Disord 2014;28(3):253-60.
27. Bae JB, Kim YJ, Han JW, Kim TH, Park JH, Lee SB, et al. Incidence of and risk factors for Alzheimer's disease and mild cognitive impairment in Korean elderly. Dement Geriatr Cogn 2015;39(1):105-15.
28. Tanthanapanyakorn P, Pathomrotsakun J, Maoon N, Joichan K, Maliamuen C. Prevalence and factors associated to cognitive impairment among elderly people in Chonnabot District, KhonKaen Province. Wichcha J 2019;38(2):67-79.
29. Deetong-on T, Puapornpong P, Pumipichet S, Benyakorn S, Kitporntheranunt M, Kongsomboon, K. Prevalence and risk factors of mild cognitive impairment in menopausal women at HRH Princess Maha Chakri Sirindhorn Medical Center. Thai J Obstet Gynaecol 2013;3(1):110-6.
30. Phanakorn L, Nanthamongkolchai S, Pitikuntang S, Munsawangsap C, Dechabunsermsak P. Factors influencing dementia in elderly women in Lumphun Province. J Public Health 2015;45(2):197-209.
31. Copper C, Sommerlad A, Lyketsos CG, Livingston G. Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. Am J Psychiatry 2015;4(1):323-34.
32. Ng TP, Feng L, Nyunt MS, Feng L, Gao Q, Lim ML, et al. Metabolic syndrome and the risk of mild cognitive impairment and progression to dementia: follow-up of the Singapore Longitudinal Ageing Study Cohort. JAMA Neurol 2016;73(4):456-63.
33. Macpherson H. Six things you can do to reduce your risk of dementia [Internet]. 2018 [cited 2020 Nov 12]. Available from: URL: https://theconversation.com/six-things-youcan-do-to-reduce-your-risk-of-dementia-9306140
34. Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D, et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc 2011;59(8):1477-83.
35. Suthisisang C. Alzheimer's disease and drugs to be aware of [Internet]. 2017 [cited 2019 Aug 28]. Available from: URL: https://pharmacy.mahidol.ac.th/th/knowledge/article/408
36. Ancelin M, Artero S, Portet F, Dupuy A, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 2006; 332(7539):455-59.
37. Kingsland J. Common drugs linked to increased risk of Alzheimer's. Medical News Today [Internet]. 2020 [cited 2020 Nov 28]. Available from: URL: https://www.medicalnewstoday.com/articles/commondrugs-linked-to-increased-risk-of-alzheimers
38. Mons U, Schottker B, Muller H, Kliegel M, Brenner H. History of lifetime smoking, smoking cessation and cognitive function in the elderly population. Eur J Epidemiol 2013; 28(10):823-31.
39. JacobL, BohlkenJ, Kostev K. Risk factors for mild cognitive impairment in German primary care practice. J Alzheimers Dis 2017; 56(1):379-84.
2. Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2017 [Internet]. 2019 [cited 2020 Nov 20]. Available from: URL: https:// thaitgri.org/?wpdmpro=situation-of-the-thaieldery-2019
3. Health Data Center, The Ministry of Public Health. Elderly population data 2016-2018 [Internet]. 2018 [cited 2020 Nov 20]. Available from: URL: https://hdcservice.moph. go.th/hdc/reports
4. Aekplakorn W. Report of the public health survey of Thailand by the 5th physical examination. Nonthaburi, Thailand: Health System Research Institute; 2014. p.231-49.
5. The Institute of Medicine and the Elderly Department of Medicine, The Ministry of Public Health. Prevention guidelines: evaluate falls in the elderly. Bangkok, Thailand: CG Tools Company Limited; 2008.
6. Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001;58(12):1985-92.
7. Alzheimer's Association. Mild cognitive impairment [Internet]. 2019 [cited 2019 Aug 28]. Available from: URL: https://www.alz. org/alzheimers-dementia/what-is-dementia/ related_conditions/mild-cognitive-impairment
8. Muangpaisan W. Dementia: prevention, assessment and care. 4th ed. Bangkok, Thailand: Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University; 2016.
9. Wongsaree C, Phunthong S. Dementia syndrome in the elderly: nursing care and caring for relatives caregiver. HUC J Health Sci 2018;22(43):166-79.
10. Department of Medical Services,The Ministry of Public Health. Development a comprehensive care system for dementia patients 2019 [Internet]. 2019 [cited 2019 Aug 24]. Available from: URL: https://www. thaihealth.or.th/Content/49850
11. Trakulsithichoke S. Prevention of dementia in older persons. J Nurs Health Care 2018;36(4):6-14.
12. Baumgart M, Snyder SM, Carrillo MC, Fazio S, Kim H, John H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement 2015;11(6):718-26.
13. Elderly Club, Buddhachinaj Phitsanulok Hospital. Performance report of Elderly Club, 2017. Phitsanulok, Thailand: Elderly Club, Buddhachinaj Phitsanulok Hospital; 2018.
14. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695-99.
15. Hemranchroj S. Cognitive impairment in medicine basic and clinical neuroscience. MoCA Thai version. Bangkok, Thailand: Chulalongkorn University Printing House; 2010.
16. Tangwongchai S, Phanasathit M, Charernboon T, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The validity of Thai version of The Montreal Cognitive Assessment (MoCA-T). Dement Neuropsychol [online]. 2009 [cited 2020 Nov 10];3 (2):172. Available from: http://demneuropsy.com.br/imageBank/pdf/dnv03n02a11.pdf
17. Rattanawat W, Nakawiro D, Visajan P. Prevalence of mild cognitive impairment (MCI) in pre-retirement period of hospital staff. J Psychiatr Assoc Thai 2018;63(1):55-64.
18. Chaimay P. Caution in using chi-square test in health science research. Thaksin Univ J 2010;13(1):55-8.
19. Praison P, Chuajedton P. Factors related to mild cognitive impairments in elderly people in Chiang Rai Province. Thai J Nurs C 2017;32(1):64-78.
20. Saowaphan J, Suwan P, Thajang S, Phonchari P, Voharndate J. Prevalence of mild cognitive impairment in older people at semi-rural community, Udonthani Province. Documents for the 4th National Conference; 2019 May 31; Rajthanee University, Ubon Ratchathanee.
21. Undara W, Singhasenee U, Wongnitikul P. The study of dementia, knowledge and prevention of dementia and the demographic data in the Elderly Association of Royal Thai Air Force Nursing College. J Police Nurs 2016;8(1):23-33.
22. Saunders N, Summers M. Attention and working memory deficits in mild cognitive impairment [Internet]. 2010 [cited 2020 Nov 10]. Available from: URL: https://www. researchgate.net/publication/26854413_Attention_and_working_memory_ deficits_in_ mild_cognitive_impairment
23. World Health Organization. Dementia cases set to triple by 2050 but still largely ignored [Internet]. 2012 [cited 2020 Nov 20]. Available from: URL: https://www.who.int/mediacentre/news/releases/2012/dementia_20120411/en/
24. Petersen R, Lopez O, Armstrong M, Getchius T, Ganguli M, Gloss D, et al. Practice guideline update summary: mild cognitive impairment. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90 (3):126-35.
25. Yodmai K. Family role and caring an aging with dementia in community. J Public Health Nurs 2017;31(1):189-204.
26. Brenowitz W, Kukull W, Beresford S, Monsell S, Williams E. Social relationships and risk of incident mild cognitive impairment in U.S. Alzheimer's Disease Centers. Alzheimer Dis Assoc Disord 2014;28(3):253-60.
27. Bae JB, Kim YJ, Han JW, Kim TH, Park JH, Lee SB, et al. Incidence of and risk factors for Alzheimer's disease and mild cognitive impairment in Korean elderly. Dement Geriatr Cogn 2015;39(1):105-15.
28. Tanthanapanyakorn P, Pathomrotsakun J, Maoon N, Joichan K, Maliamuen C. Prevalence and factors associated to cognitive impairment among elderly people in Chonnabot District, KhonKaen Province. Wichcha J 2019;38(2):67-79.
29. Deetong-on T, Puapornpong P, Pumipichet S, Benyakorn S, Kitporntheranunt M, Kongsomboon, K. Prevalence and risk factors of mild cognitive impairment in menopausal women at HRH Princess Maha Chakri Sirindhorn Medical Center. Thai J Obstet Gynaecol 2013;3(1):110-6.
30. Phanakorn L, Nanthamongkolchai S, Pitikuntang S, Munsawangsap C, Dechabunsermsak P. Factors influencing dementia in elderly women in Lumphun Province. J Public Health 2015;45(2):197-209.
31. Copper C, Sommerlad A, Lyketsos CG, Livingston G. Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. Am J Psychiatry 2015;4(1):323-34.
32. Ng TP, Feng L, Nyunt MS, Feng L, Gao Q, Lim ML, et al. Metabolic syndrome and the risk of mild cognitive impairment and progression to dementia: follow-up of the Singapore Longitudinal Ageing Study Cohort. JAMA Neurol 2016;73(4):456-63.
33. Macpherson H. Six things you can do to reduce your risk of dementia [Internet]. 2018 [cited 2020 Nov 12]. Available from: URL: https://theconversation.com/six-things-youcan-do-to-reduce-your-risk-of-dementia-9306140
34. Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D, et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc 2011;59(8):1477-83.
35. Suthisisang C. Alzheimer's disease and drugs to be aware of [Internet]. 2017 [cited 2019 Aug 28]. Available from: URL: https://pharmacy.mahidol.ac.th/th/knowledge/article/408
36. Ancelin M, Artero S, Portet F, Dupuy A, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 2006; 332(7539):455-59.
37. Kingsland J. Common drugs linked to increased risk of Alzheimer's. Medical News Today [Internet]. 2020 [cited 2020 Nov 28]. Available from: URL: https://www.medicalnewstoday.com/articles/commondrugs-linked-to-increased-risk-of-alzheimers
38. Mons U, Schottker B, Muller H, Kliegel M, Brenner H. History of lifetime smoking, smoking cessation and cognitive function in the elderly population. Eur J Epidemiol 2013; 28(10):823-31.
39. JacobL, BohlkenJ, Kostev K. Risk factors for mild cognitive impairment in German primary care practice. J Alzheimers Dis 2017; 56(1):379-84.
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