رابطه مهارت‌هاي بينايي ساختاري و فعاليت‌هاي روزمره زندگي سالمندان مقيم جامعه

The Relationship between Visual Constructive Abilities and Activity of Daily Living in Home Dwelling Elderly Population

اهداف اختلالات شناختی، یكی از اختلالات شایع همراه با معلولیت شدید و پیش‌رونده در دوره سالمندی است. مطالعات نشان می‌دهد كه حدود 5 درصد از افراد 65 سال و بالاتر به نقص شناختی واضح دچارند. از میان مهارت‌های شناختی، مهارت‌های ساختار بینایی یكی از پیش‌بینی‌كننده‌های مهم برای میزان دریافت كمك و حمایت در سالمندان محسوب می‌شود. كاهش بینایی به‌عنوان بخشی از شناخت، با اجرای فعالیت‌ها مرتبط است؛ بنابراین شناسایی این مشكلات در روند درمان و كسب استقلال در زندگی روزمره این افراد تأثیر بسزایی دارد. مواد و روش ها در این مطالعه توصیفی-تحلیلی مقطعی 47 سالمند ساكن جامعه مراجعه‌كننده به كانون جهان‌دیدگان شهر شیراز در محدوده سنی 60 تا 80 سال به روش نمونه‌گیری دردسترس انتخاب شدند. اطلاعات از این طریق جمع‌آوری شد: مشاهده، مصاحبه، انجام خُرده‌آزمون مهارت‌های ساختار بینایی آزمون لوتكا برای ارزیابی مهارت‌های شناختی و شاخص كتز به‌منظور ارزیابی فعالیت‌های روزمره زندگی. همچنین برای تجزیه‌وتحلیل داده‌ها از نرم‌افزار SPSS و آزمون همبستگی پیرسون استفاده شد. یافته ها شركت‌كنندگان شامل 9 زن و 38 مرد با میانگین سنی66/4±94/69 سال بودند. یافته‌های پژوهش نشان داد كه سازمان‌دهی بینایی-حركتی سالمندان ساكن جامعه با خُرده‌آزمون‌های غذاخوردن و لباس‌پوشیدن آزمون كتز ارتباط معنی‌داری دارد (05/0≥P). این در حالی است كه بین خُرده‌آزمون بینایی-حركتی آزمون لوتكا با خُرده‌آزمون‌های حمام‌كردن، جابه‌جایی در منزل، دست‌شویی‌رفتن و كنترل ادرار و مدفوع ارتباط معنی‌داری یافت نشد. همچنین بین نمره كلی آزمون كتز با خُرده‌آزمون بینایی حركتی آزمون لوتكا نیز ارتباط معنی‌داری وجود نداشت (05/0

Objectives Cognitive deficits are one of the most severe impairments which lead to disability in seniors. The investigations showed that about 5% of 60 years and older people suffer obvious cognitive impairments. As a cognitive sub-scale, reduced visual abilities are related to doing activities, so Cognitive skills especially visual constructive skills, are one of the most important predictors of dependency in aging and identifying its problems have a considerable impact in their independency in daily living skills, besides Self-care can be viewed as a practice performed by individuals for their own benefit, to maintain life and wellbeing and is a key element in the proper maintenance of independency. Activity of daily living (ADL) can display personal life independency and is considered as a morbidity index. To determine whether cognitive impairment is associated with changes in self-care behavior and Activities of daily living in older subjects we assess visual abilities and activity of daily living. Methods & Materials  In this cross-sectional study, 47 individuals aged 60 to 80 years were recruited from Jahandidegan club in Shiraz using simple random sampling. Data were collected through observation and interview. Then they were evaluated by "visual constructive ability" sub-scale from LOTCA battery to assess associated skill and "Katz Index" to assess their ADL. SPSS software and Pearson correlation test were used for data analysis.  Results The mean age of the included samples (9 women and 38 men) was 69.94±4.66 years. Poorer scores in cognitive domains predicted functional decline in some sub scales. There was a significant correlation between visual constructive ability with eating and dressing (P≥0.05); however, no significant correlation was found between this sub-scale with bathing, moving, toileting, and bowel control and also between the total score of two tests. Conclusion According to this research, there was a significant correlation between visual constructive abilities and dressing and eating activities. According to the fact that Basic ADLs are associated with motor function, whereas instrumental ADLs are typically correlated to cognitive functions and also basic activities of daily living (BADL) are part of daily life schedule, they may have converted to habituations and routines in daily living. As a result, a weak correlation was observed between cognition and personal independency that may result from the less demanding cognitive processing tasks. Katz Index only evaluates personal independency in basic activities of daily living and does not consider their implications while aging has an impact on performing activities and in many cases the work is finally able to run in spite of many mistakes.