Self-Perception and Judgment of Mobility among Elderly Hospitalized Patients with Cognitive Decline

DOI Web Site
  • SHINOZAKI Mio
    Department of Neurology, National Center for Geriatrics and Gerontology
  • YAMAMOTO Shigemi
    Department of Neurology, National Center for Geriatrics and Gerontology
  • KAKIYA Masayo
    Department of Neurology, National Center for Geriatrics and Gerontology
  • KAJITA Chikako
    Nursing Department, National Center for Geriatrics and Gerontology
  • OHTA Ryuji
    Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology
  • TANIMOTO Masanori
    Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology
  • YAMAOKA Akiko
    Department of Neurology, National Center for Geriatrics and Gerontology
  • TAKEMURA Marie
    Department of Orthopedics, National Center for Geriatrics and Gerontology
  • SATAKE Shosuke
    Department of Frailty Research, National Center for Geriatrics and Gerontology
  • KONDO Izumi
    Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology
  • ARAHATA Yutaka
    Department of Neurology, National Center for Geriatrics and Gerontology

Bibliographic Information

Other Title
  • 認知機能の低下した高齢入院患者における移動能力の認識・判断過程
  • 認知機能の低下した高齢入院患者における移動能力の認識・判断過程 : 誤判断に伴う転倒の認知モデル
  • ニンチ キノウ ノ テイカ シタ コウレイ ニュウイン カンジャ ニ オケル イドウ ノウリョク ノ ニンシキ ・ ハンダン カテイ : ゴハンダン ニ トモナウ テントウ ノ ニンチ モデル
  • Cognitive Model of Falls Caused by Impaired Judgment
  • 誤判断に伴う転倒の認知モデル

Search this article

Abstract

<p>【Objective】We aimed to clarify the mechanism of falls associated with cognitive decline by investigating the cognitive processes through which patients perceived and judged their own mobility.</p><p>【Methods】We assessed 304 patients with an average age of 82 (range, 65-97) years who were hospitalized in a community-based integrated care ward after acute-phase treatment. Pre-hospitalized mobility was assessed according to information from the family. Actual mobility (Functional Independence Measure [FIM] transfer and gait), perceived mobility (physical functioning subscale on SF-8), and cognitive function (Mini-Mental State Examination [MMSE]) scores for each patient were evaluated upon admission and discharge. The presence or absence of falls was assessed three months after discharge. The participants were divided into three (high, medium, and low) or two (high and low) groups according to MMSE scores. We analyzed the cognitive processes involved in the patients’ perception and judgment of their mobility using structural equation modeling, and investigated whether a discrepancy between actual and perceived mobility affected the occurrence of falls after discharge using binomial logistic regression analysis.</p><p>【Results】Structural equation modeling indicated that self-evaluated mobility was affected by actual mobility at the time of admission in the group with high MMSE scores, and was affected by pre-hospitalized mobility in the groups with medium and low MMSE scores. Binomial logistic regression results showed that a discrepancy between actual (at discharge) mobility and perceived (pre-hospitalized) mobility affected the occurrence of falls at three months after discharge in the group with low MMSE scores.</p><p>【Conclusion】After acute-phase treatment, elderly patients with cognitive decline overestimated their mobility based on the mental representation of their pre-hospitalized mobility, and the inaccurate perception can lead to risky judgment and an increased risk of falls.</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top