Japanese

Title	音楽療法により自発性が向上した認知症患者の1例
Subtitle	症例報告
Authors	渡邉典子*, 相馬ひとみ*, 吉野彩香**, 和田麻季子***, 藤岡俊樹****
Authors (kana)
Organization	*東邦大学医療センター大橋病院看護部, **東邦大学医療センター大橋病院患者サポートセンター, ***東邦大学医療センター大橋病院薬剤部, ****東邦大学医療センター大橋病院脳神経内科
Journal	神経治療学
Volume	39
Number	4
Page	723-726
Year/Month	2022 /
Article	報告
Publisher	日本神経治療学会
Abstract	〔要約〕症例は90歳男性. 10年前にAlzheimer病と血管性認知症と診断され, 薬剤治療を受けていたが, 重症心不全を発症してICUに入院. 心不全状態は改善したがせん妄症状と, 自発性の低下, 不眠, 日中の傾眠, 食事摂取不良をきたしたため, 睡眠薬, 抗認知症薬, 鎮静薬などの投与に加え, 認知症ケアチームが介入した. 患者は認知症発症以前から音楽を趣味としていたため, 好きな楽曲を中心に週3回, リハビリテーションの時に聴かせ, 歌う様に促したところ, 1ヶ月後には自発的にリズムをとり歌うようになった. 同時にABC認知症スケールは50点から60点に改善, 日中の傾眠も改善し自宅退院できた. 音楽療法の効果は薬物療法と違いエビデンスは低いとされているが本例では音楽療法の開始に伴い日常生活動作の改善が明らかとなった. 今後, 音楽療法の科学的根拠を求めた検討が必要と思われた.
Practice	臨床医学：内科系
Keywords	dementia, music therapy, reminiscence therapy, ABC Dementia Scale

English

Title	A case of dementia with rejective attitude successfully treated with music therapy
Subtitle
Authors	Noriko WATANABE*, Hitomi SOMA*, Ayaka YOSHINO**, Makiko WADA***, Toshiki FUJIOKA****
Authors (kana)
Organization	*Nursing Department, Toho University Ohashi Medical Center, **Patient Supporting Center, Toho University Ohashi Medical Center, ***Pharmaceutical Department, Toho University Ohashi Medical Center, ****Department of Neurology, Toho University Ohashi Medical Center
Journal	Neurological Therapeutics
Volume	39
Number	4
Page	723-726
Year/Month	2022 /
Article	Report
Publisher	Japanese Society of Neurological Therapeutics
Abstract	An 90-year-old man with 10-year history of dementia due to Alzheimer disease admitted to our hospital because of severe hear failure. He had been prescribed donepezil hydrochloride for about ten years. He once was a member of domestic chorus group for his pleasure. After his admission he underwent non-invasive positive pressure ventilation management along with multidisciplinary treatment in the intensive care unit where he developed delirium. Dexmedetomidine hydrochloride, risperidone and eszopiclone relief his symptom only partially, thereafter he refused eating and his circadian rhythm deteriorated. Daily session of singing songs that he used sing previously was added to the standard rehabilitation program three times a week. After one week active and initiative attitude were recovered and after one month his ABC-Dementia Scale indicated improvement from 50 point to 60 point, then he discharged to his home. The efficacy of music therapy, one of non-drug therapies, is not yet proven. However it might be an effective intervention against behavioral and psychological symptom of dementia. Further investigation is warranted to gain scientific evidence of musictherapy.
Practice	Clinical internal medicine
Keywords	dementia, music therapy, reminiscence therapy, ABC Dementia Scale

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