치매 심각도에 따른 뇌졸중 환자의 도구적 일상생활 능력 변화와 인지 기능과의 관계

Abstract

Background: Although many stroke patients suffer from both impairments in instrumental activities of daily living (IADL) and cognitive dysfunctions, there has been little investigation into the relationship between IADL deficits and cognitive ability in stroke patients. This study was conducted in order to examine the relationship between IADL deficits and the severity of dementia in stroke patients and to determine the cognitive functions that are strongly related to the IADL. Methods: The subjects included 148 stroke patients who were given a comprehensive neuropsychological evaluation. They were divided into four groups (normal, questionable, mild, & moderate dementia groups) based on their CDR scores. Their caregivers completed the K-IADL and Modified Barthel Index. Results: The results of the evaluations indicated that the questionable dementia group showed significantly greater impairment than the normal group on four items (household chores, cooking, hobbies, and fixing the house) in the K-IADL. The mild dementia group showed significantly greater impairment than the questionable dementia group on six items (using transportation, managing finances, using the telephone, responsibility for own medication, recent memory, and watching TV) in the K-IADL. The moderate dementia group showed greater impairment than the mild dementia group on all of the items in the K-IADL. Hierarchical multiple regression analyses revealed that the RCFT-copy score is the best predictor of K-IADL score, regardless of the severity of dementia. Conclusion: These results showed that impairment in the IADL can be seen even in very mild levels of cognitive deficit. The results also suggest that visuospatial ability is significantly related to the IADL.