| Abstract: | 中文摘要研究背景：經統計2018年在台灣65歲以上高齡者已達331萬人，已正式邁入「高齡社會」，其中輕度認知障礙(Mild Cognitive Impairment; MCI)者約有60萬人且逐年增加。MCI高齡者認知缺損往往先發生在工具性日常生活功能(instrumental activities of daily living, IADL)如財務管理、使用電話等，且若未及時介入逆轉，很可能轉變成失智症。然而過去卻缺乏有效策略介入IADL，僅期待透過傳統認知訓練如桌上遊戲來提升認知功能的同時也能改善IADL，但IADL是否有所提升仍不確定。再者，這些高齡者即使認知功能提升，仍很可能因IADL下降，使MCI再度復發。因此，若能針對IADL設計創新桌上遊戲課程，將有機會同時提升MCI高齡者之IADL與認知功能。本研究將使用創新桌上遊戲珊米機器人（動態機器人模擬生活情境）完成IADL任務，幫助MCI高齡者將IADL任務類化至真實生活中。研究目的：本研究旨在探討創新桌上遊戲珊米機器人活動介入前後，對於MCI高齡者認知與日常生活功能之成效。研究方法：本研究共招募60位MCI高齡者作為研究對象，採隨機控制實驗研究（randomized controlled trial），並進行塊狀隨機分配法(Blocked Randomization)方式將MCI高齡者分派至兩組，其中30人為實驗組（珊米機器人活動介入組）、30人為控制組（一般健康促進活動介入組），各組MCI高齡者每次介入兩小時，一週一次，共計十二次，並在介入前、後進行評估認知與IADL，評量量表包括：(1)巴氏日常生活量表（The Barthel Index,BADLs）；(2)聖路易大學心智狀態測驗(Saint Louis University Mental Status Exam ,SLUMSE)；(3)功能性日常生活活動能力量表(Instrumental activities of daily living scale, IADLs)；(4)情境式測驗(Contextual Memory Test, CMT)；(5)路徑描繪測驗(Trail Making Test, TMT)。結果發現：珊米機器人活動介入在每週2小時，12週的訓練中，是能夠改善MCI高齡者的立即性記憶力、記憶策略、執行功能及功能性日常活動，但在總體認知功能及記憶覺察改善程度上並無差異，反而一般健康促進活動介入在記憶覺察程度改善的趨勢較珊米機器人活動介入來得多。而在延遲性記憶力中，兩組間無論前後測皆沒有顯著的進步及差異性。本研究所選用的珊米機器人活動介入中是有帶領師資限制的，若無加入師資設計之活動內容搭配使用的話，是沒有相同程度的療效，期許未來可將活動內容標準化，並設計成參與者可自行操作學習而無需師資教學，藉以有助於持續改善及維持MCI高齡者的功能性日常活動。
AbstractBackground: According to statistics in 2018, the number of elderly people over the age of 65 in Taiwan has reached 3.31 million, and has officially entered the "age society". There are about 600,000 people with Mild Cognitive Impairment (MCI) increasing year by year. MCI elderly people cognitive predisposition often occurs first in instrumental activities of daily living (IADL) such as financial management, telephone use, etc., and if not promptly involved in reversal, it is likely to turn into dementia. However, in the past, there was no effective strategy to intervent in IADL. It only hopes to improve the cognitive function through traditional cognitive training such as table games, but it can also improve IADL. However, it is still uncertain whether IADL will be improved. Moreover, even if the cognitive function is elevated, these MCI elderly people are likely to relapse due to the decline of IADL. Therefore, if you can design new table games for IADL, you will have the opportunity to simultaneously improve the IADL and cognitive functions of MCI elderly people. This study will use the new table game such as Sammy robot (dynamic robot simulation life situation) to complete the IADL task, helping MCI elderly people to transfer the IADL task into real life.Purposes: This study aims to explore the cognition and daily life of MCI elderly people before and after the intervention of the new table game such as Sammi robot project.Methods:60 MCI elderly people were recruited in this study. Randomized controlled trials were conducted and Blocked Randomization was used to assign MCI elderly people to the two groups, 30 of whom were experimental groups. (Sami robot activity intervention group), 30 people control group (general health promotion activity intervention group), each group of MCI elderly people involved in two hours each time, once a week, 12 weeks, and assessment assessment before and after intervention With IADL, the assessment scale includes: (1) The Barthel Index (BADLs); (2) Saint Louis University Mental Status Exam (SLUMSE); (3) Instrumental activities of daily living scale (IADLs); (4) Contextual Memory Test (CMT); (5) Trail Making Test (TMT).Results: The intervention of Sammy's robot activity in 2 hours per week and 12 weeks of training can improve immediate memory, memory strategy, executive function and functional daily activities of MCI elderly people, but in terms of overall cognitive function and memory awareness improvement is no difference. On the contrary, the trend of general health promotion activity intervention in the improvement of memory awareness is much more than that of Sammi robot activity intervention. In delayed memory, there was no significant improvement and difference between the two groups regardless of the pre- and post-test. The Sammy robot activity intervention selected by this institute has restrictions on leaders. If there is no matching with the content of the teacher-designed activities, there will be no equal degree of curative effect. It is hoped that the content of the activities can be standardized in the future and designed as participants It can operate and learn by itself without teacher teaching, thereby helping to continuously improve and maintain the functional daily activities of MCI elderly people. |
