65 yaş üstü demanslı hastalarda dengenin fonksiyonel durum ve yaşam kalitesi ile ilişkisi
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Date
2016
Authors
Ok, Nurfiliz
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Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Demans, beyinde kronik ilerleyici dejeneratif tutuluma bağlı olarak bilişsel fonksiyonlarda gerileme ile giden klinik bir sendromdur. Demansiyel durumlarda, denge ve yürüme bozukluklarının yanı sıra yaşam kalitesinde azalma da klinik tabloya eşlik etmektedir. Bu çalışmada, 65 yaş üstü erken evre demanslı hastalarda dengenin, fonksiyonel durum ve yaşam kalitesi ile ilişkisinin değerlendirilmesi amaçlanmıştır. Çalışmaya; bilişsel fonksiyonları iletişim için yeterli olan (Mini Mental Test skoru 20'nin üzerinde olan) yatağa veya tekerlekli sandalyeye bağımlı olmayan, 65 yaş üstü 104 erken evre demanslı hasta ve 131 sağlıklı kontrol olmak üzere 235 olgu alındı. Olguların fonksiyonel durumu fonksiyonel ambulasyon skalası (FAS) ile belirlendi. Yürüme hızı süreli kalk yürü testi (SKYT), dengesi Berg Denge Ölçeği (BDÖ) ile yaşam kalitesi Kısa Form 36 (KF-36) ile ve bilişsel durumu Standardize Mini Mental Test (SMMT) ile değerlendirildi. Depresif semptomların varlığı; sağlıklı kontrolde Geriatrik Depresyon Ölçeği (GDÖ), demanslı hastalarda Cornell Demansta Depresyon Ölçeği (CDDÖ) ile değerlendirildi. Olguların yaş, cinsiyet, kilo, boy, VKI, medeni durum, eğitim düzeyi, ek hastalık ve ek ilaç kullanımını içeren demografik verileri kaydedildi. Demanslı hastalarda, KF-36'nın alt parametrelerinden ağrı, genel sağlık ve sosyal fonksiyon dışında bütün alt parametreleri ve özet skorları istatistiksel olarak anlamlı düzeyde düşük bulundu. SKYT süresi anlamlı olarak yüksekti. FAS ve BDÖ de anlamlı düzeyde düşük bulundu. Korelasyon analizlerinde BDÖ ile; FAS arasında pozitif korelasyon, SKYT arasında kuvvetli negatif korelasyon, KF-36 alt parametreleri ve özet komponentleri arasında ise pozitif korelasyon bulundu. Sonuç olarak bu çalışmada, erken evre demanslılarda dengenin bozulduğunu ve bunun yaşam kalitesini ve fonksiyonelliği azalttığını belirledik.
Dementia, is a clinical syndrome leading to the decline in cognitive function due to chronic progressive degenerative involvement.of brain. Demantial case, is a clinical entity that is accompanied by the balance and gait disorders, as well as reduction in quality of life. In this study, we aimed to evaluate the relationship between balance, functional status and quality of life in patients over 65 years in the early stages of dementia. 235 cases were enrolled incluiding 104 early stage dementia and 131 healthy control whose cognitive functions are sufficient for communication (Mini Mental State Examination score over 20 points) and not dependent on the bed or a wheelchair. Functional status of the patients was determined with functional ambulation scale (FAS). Walking speed were evaluated time up and go test (TUG), the balance with Berg Balance Scale (BBS), quality of life with Short Form 36 (SF-36), and cognitive status with Standardized Mini-Mental State Examination (MMSE). The presence of depressive symptoms; Geriatric Depression Scale (GDS) in healthy controls, Cornell Scale for Depression in Dementia Patients with dementia (CSDD) were evaluated. Age, gender, weight, height, BMI, marital status, education level and demographic data, including the use of concomitant diseases and concomitant medication were recorded. In patients with dementia, outside of pain, general health and social functions parameters, all of the SF-36 sub-parameters and summary scores were statistically significantly lower. TUG duration was significantly higher. FAS and BBS were also found to be significantly lower. In correlation analysis BBS; is found positive correlation with FAS, the strong negative correlation between TUG and a positive correlation with SF-36 sub-parameters and summary scores. Consequently in this study, we have determined that balance deteriorated and reduction in quality of life and functionality in early stage dementia.
Dementia, is a clinical syndrome leading to the decline in cognitive function due to chronic progressive degenerative involvement.of brain. Demantial case, is a clinical entity that is accompanied by the balance and gait disorders, as well as reduction in quality of life. In this study, we aimed to evaluate the relationship between balance, functional status and quality of life in patients over 65 years in the early stages of dementia. 235 cases were enrolled incluiding 104 early stage dementia and 131 healthy control whose cognitive functions are sufficient for communication (Mini Mental State Examination score over 20 points) and not dependent on the bed or a wheelchair. Functional status of the patients was determined with functional ambulation scale (FAS). Walking speed were evaluated time up and go test (TUG), the balance with Berg Balance Scale (BBS), quality of life with Short Form 36 (SF-36), and cognitive status with Standardized Mini-Mental State Examination (MMSE). The presence of depressive symptoms; Geriatric Depression Scale (GDS) in healthy controls, Cornell Scale for Depression in Dementia Patients with dementia (CSDD) were evaluated. Age, gender, weight, height, BMI, marital status, education level and demographic data, including the use of concomitant diseases and concomitant medication were recorded. In patients with dementia, outside of pain, general health and social functions parameters, all of the SF-36 sub-parameters and summary scores were statistically significantly lower. TUG duration was significantly higher. FAS and BBS were also found to be significantly lower. In correlation analysis BBS; is found positive correlation with FAS, the strong negative correlation between TUG and a positive correlation with SF-36 sub-parameters and summary scores. Consequently in this study, we have determined that balance deteriorated and reduction in quality of life and functionality in early stage dementia.
Description
Keywords
Demans, Denge, Fonksiyonel durum, Yaşam kalitesi, Dementia, Balance, Functional status, Quality of life
Citation
Ok, N. (2016). 65 yaş üstü demanslı hastalarda dengenin fonksiyonel durum ve yaşam kalitesi ile ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.