沖縄百寿者のＡＤＬの変遷に関する研究

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タイトル別名
  • Chronological Study Concerning ADL among Okinawan Centenarians.
  • オキナワ ヒャクジュシャ ノ ADL ノ ヘンセン ニカンスルケンキュウ

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Since 1976 medicobiological and sociological surveys have been carried out upon centenarians in Okinawa. Recently dementia and disability have increased among centenarians. In order to determine the statistical significance, ADL (Activities of Daily Living) scores among Okinawan centenarians were compared; 43 subjects were studied from the 1970's (1976-1980), 99 subjects from the 1980's (1986-1988), and 109 subjects from the 1990's (1992-1994). ADL scores of each centenarian were recorded by the same researchers at the University of the Ryukyus Hospital, based on observation and examination of the centenarians where they lived. Five categories of self sufficiency were defined; completely independent, independent but slow, independent with difficulty, partially dependent, and completely dependent. There were seven physical tasks scored; taking meals, bowel and bladder continence, ability to rise from a toilet, ability to stand, extent of general activities, ability to bathe, and ability to dress oneself. Their sensory functions (auditory acuity and eyesight) and cognitive abilities (comprehension and self-expression) were also scored. Declining rates of total ADL scores were more marked between the 1970's and the 1980's than between the 1980's and the early 1990's. It was also more remarkable in institutionalized centenarians than in centenarians living at home. Decline in physical activities was more distinct in institutionalized than in home-living centenarians. On the other hand, cognitive abilities declined more among centenarian living at home than among institutionalized centenarians. The population of centenarians has increased 23 times over the past 22 years in Okinawa. Human life span has been remarkably extended by advanced medical technology, physically easier life style, and improvement in overall social welfare. At the same time, the rate of institutionalization has increased due to the increased demand for care of the disabled elderly. The decline of average ADL scores among centenarians might be a reflection of this increase in institutionalization. Adequate and sufficient care might increase longevity to around a hundred years even in the disabled. However, we have to be careful and realize that all centenarian have their own unique level of ADL and life style that differs from what they might have had before. Otherwise, incorrect conclusions may be derived from research of the elderly. Such being the case, the kind of activities which each centenarian has been and is engaging in, should be part of all research reports on medicobiological studies of centenarians. Therefore, it should be noted that data from centenarians with debilities might be quite skewed due to their physiological conditions. Hopefully, instead of just being an issue of maintaining the health of the elderly, the quality of life for centenarians must also be taken into consideration, as well as their value to society, leading to a better living for centenarian.

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