치매의 재활치료 및 비약물치료

Abstract

Dementia is a clinical syndrome which shows gradual loss of cognition, ability for daily living and diverse behavioral and psychological symptoms. The etiology of dementia has been known more than seventy underlying pathologies and non-pharmacological management is a principal method not only for cognitive dysfunction in early stage but also for behavioral and psychological symptoms of dementia (BPSD) in late stage. The application of non-pharmacological approach usually is classified into prevention of dementia, cognitive intervention and modalities for activities of daily living and BPSD. The preventive methods for dementia encompass modification of cardiovascular risk factors, augmentation of physical activities and exercise. Cognitive intervention includes cognitive stimulation, cognitive training and cognitive rehabilitation. Managements for BPSD comprise the therapies using aroma, music and light, and massage, multi-sensory stimulation, behavioral management and etc. However, many meta-analyses reported that there were limited evidences in the effectiveness of non-pharmacological approaches for dementia because of limited number of large scale, high-quality studies. In addition, application of non-pharmacological approaches should be considered for care-giver’s need and the functional status of the patients.