【アブストラクト】
目的：認知症グループホームケアの有効性を定量的評価に基づいて示すこと。

方法：全国の認知症グループホームに協力を依頼し、既存入居群（3か月以上入居）484名では入居時と3か月後の2時点で、新規入居群では入居時、1か月後、3か月後および可能であれば入居前の4時点で調査を行った。ケアの効果指標にはBPSDの指標としてNPI-NHとその職業的負担度（NPI-D）、QOLの指標にはshort QOL-Dを用い、統計学的に分析した。結果：1）入居時と3か月後を比較すると、既存入居群484名は、NPI-NHがわずかな有意の改善を示し、職業的負担度とshort QOL-Dは有意な変化を示さなかった。一方、新規入居群71名は、いずれの指標も有意に改善した。新規入居群の変化は、既存入居群の変化と比べたとき、BPSDが改善傾向、NPI-Dによる職業的負担度とQOLが有意な改善（交互作用）を示した。2）新規入居群で入居前評価と入居時・1か月後のデータが揃った68名では、いずれの指標も有意な改善を示し、既存入居群の値に近づいた。3）入居時と1か月後が揃った新規入居群114名では、3指標とも有意な改善を示した。抗 精神病薬が新規入居から1か月後の時点で投与されていた20名と非投与94名を比較すると、非投与群でのみ有意な改善が示された。3指標の改善効果は抗精神病薬投与群と非投与群で有意な交互作用がなかった。

結論：認知症グループホームケアにより、入居から3か月後にはBPSDが安定してQOLが高まり、既存入居群と変わらないレベルになることを示した。さらに、この効果は抗精神病薬投与によるものではないと示唆された。

【アブストラクト】
認知症は、単に病気に伴う症状と捉えるだけでなく、周囲の人びととの間で徐々に達成されていくコミュニケーション上のトラブルと捉えることができる．このような観点から、本稿では、認知症の始まりに関する語りの分析を行い、認知症に関する人間の認知・行動について議論する．

【アブストラクト】
本研究は，今後急速に高齢化する東京圏の生活環境下において，家族や介護者の介護負担，人員不足，認知症や独居などの問題に対する福祉機器や介護ロボットの有用性を検討した．一都三県の高齢者施設を対象に，アンケート方式による意識調査を行い，得られた選択肢回答と自由回答をもとにクロス集計とテキストマイニング分析を行った．その結果，調査施設から認知症者に対する介護ロボットの利用が部分的に活用可能である，という肯定的な意見が得られた．抽出語からは医療施設との連携の有用性が認められ，可視化された文脈からは介護する側にとってもされる側にとっても気軽に購入できること，認知症者の個別ケアにおいて専門にカスタマイズできること，「家族」「予防」「会話」の補完によって心の安定に寄与できるような介護ロボットが理想であることが確認できた．問題解決の選択肢の一つとして，施設が介護ロボットを導入するにあたっては，費用対効果，操作方法，効果測定など施設専用の経営システムを構築し活用を図ることが必要である．

【アブストラクト】
Objectives: In this study, we examined whether a combined regimen of a short-term nap and a light physical exercise is effective in improving sleep among elderly individuals with mild-to-moderate dementia in communal living group homes.

Methods: Twenty-three female residents (aged 87.4±5.6 years) living in two group homes for the elderly with dementia were included in the present study. After undergoing an assessment for eligibility, they were randomly allocated to either the study group (N=11), who participated in the regimen of a short-term nap (<30 min) and light physical exercise for four weeks, or the control group (N=12), who received the usual nursing care without participating in the nap and exercise regimen. The lengths of sleep time and wake time were measured using a sleep monitor with a radiofrequency motion sensor. The frequencies of nocturnal behavioral and psychological symptoms associated with dementia including excitement, violence, night delirium, wandering, and unhygienic behavior were investigated throughout the study period.

Results: The subjects participating in the nap and physical exercise regimen showed a significant increase in sleep efficacy as well as a reduction in the total nocturnal wake time, whereas no clear change was observed in the control subjects. The frequencies of nocturnal episodes of urination in the study group also decreased during the course of the study. However, there was no significant decrease in the frequencies of nocturnal behavioral or psychological symptoms associated with dementia.

Conclusions: The findings of this study suggest that a short-term nap and a light physical exercise may be effective in adjusting the sleep-wake biorhythm in elderly patients with mild-to-moderate dementia and may improve sleep among these individuals.

【アブストラクト】
本研究は， 認知症に伴う行動・心理症状（Behavioral and Psychological Symptoms ofDementia：以下，BPSD)の背景因子を捉えるためのケアの視点を明らかにするためにCiNiiおよびJ-STAGEを活用した文献研究を実施した．論文145本が対象となり，更に先行研究に基づき5要因（身体的要因，精神的要因，環境的要因，個人的要因，介護者要因）を抽出し，その後分類した．分類結果は，①BPSDの現状把握のための背景因子，②介護施設の現状，③実践的アプローチの現状の3つになった．この結果から，施設での多忙な業務の中でも5要因に着目することでBPSDの背景因子を推定できる可能性が明らかになった．また，介護負担感の概念の広さが，隣接する研究領域に重複させ，分類を困難にしている理由として考えられた．今後は，介護負担感の概念整理と共に本研究で明らかになった5要因に基づく背景因子の推定を実施した上でのケアが，利用者のBPSD減少やQOL向上，更に介護職員の介護負担感に与える影響を明らかにする必要がある

In this research, in order to clarify the viewpoint of care for grasping background factors ofbehavioral and psychological symptoms of dementia (hereinafter referred to as BPSD), a reviewresearch was conducted through utilizing CiNii and J-STAGE. With 145 papers as a subject,based on the previous researches, 5 factors (physical factors, mental factors, environmentalfactors, personal factors, and caregiver's factors) were extracted, and classified afterwards.Consequently, they were classified into the followings; (1) Background factors for grasping thecurrent status of BPSD, (2) Current status of nursing-care facilities, and (3) Current status ofpractical approach. From this result, it has become clear that the background factors of BPSDcan be estimated through focusing on 5 factors despite busy tasks at facilities. Additionally,it was deemed that a broad concept of caregiver's burden made adjacent research areasoverlapped, which resulted in difficult classification. From this time on, it is necessary to clarifythe effects of decreases in users BPSD, QOL improvements, and caregiver's burden exertedby the care in which not only the concepts of caregiver's burden were organized but also thebackground factors based on the 5 factors clarified in this research.

【アブストラクト】
わが国における認知症高齢者の増加，認知症施策推進総合戦略（新オレンジプラン）の策定などに伴い，これまで以上に認知症に対する関心が高まっている．しかし，認知症という言葉は身近になっているにもかかわらず，社会における認知症スティグマが軽減されているとは言い難い現状がある．このような背景から，認知症スティグマに着目した研究が増加しつつある．一方，認知症高齢者と高齢者ケア専門職，双方の認知症スティグマに着目した研究は少ない．そこで，本研究では文献研究の手法を用いて先行研究を踏まえ，本研究における認知症スティグマを定義するための理路を提示した．また，認知症のアセスメントとケアの現状と課題についても言及し，エビデンスとナラティヴに関する先行研究からの知見を援用した．以上の結果を統合し，実践への提言として，オノマトペ（擬音語・擬態語）を認知症ケアとアセスメントに使用することの可能性をまとめた．

Interest in dementia has been increasing recently due to the growing number of elderlypeople with dementia in Japan, and the formulation of the Japanese national dementia strategy（New Orange Plan）. Despite the situation, the stigma around dementia has not been reducedin society. While such background has increased the number of studies focusing on the stigmaaround dementia, there have only been a few studies focusing on the stigma of dementia fromthe perspectives of both the elderly with dementia and elderly care professionals. The aimof this study is to provide a rationale for defining the stigma of dementia based on review.Additionally, I mention the situation and challenges for dementia care and its assessment,and employ findings from prior studies on evidence and narrative. I integrate the results ofthe study and compiled the possibilities to use onomatopoeia （echoic and mimetic words） fordementia care and its assessment as a recommendation for dementia care practice."

【アブストラクト】
目的：本研究の目的は，稲作を中心とした農業ケア・プログラムが認知機能障害をもつ高齢者の社会的包摂を実現するためのプログラムとして実行可能性があるかどうかを検証することである．

方法：新潟県内の病院に入院・通院している認知症および軽度認知障害をもつ高齢者8名（男性7名，女性1名，平均年齢68.3歳）を対象に，週1回90分，計25回の稲作を中心とした農作業のプログラムを行った．プログラムの実行可能性を検討するために，プログラム期間中の観察により対象者の作業の安全性と自立度を評価し，プログラムの実施前と終了時に認知機能と精神的健康（well-being，うつ）を評価した．また，プログラム終了時に対象者および施設職員に聞き取り調査を実施し，プログラムによる社会参加や感情への影響を評価した．結果：プログラムの平均参加率は93.0％で脱落者はいなかった．事故はなく，対象者はおおむね自立して作業ができた．プログラム実施前には精神的健康不良またはうつ疑いに該当する者が2名いたが，参加後にはいずれも該当する者はいなかった．プログラム終了時に実施した対象者および施設職員への聞き取り調査の回答からは，プログラムへの参加によって，対象者に仲間意識や役割意識，ポジティブな感情が生じたことが示唆された．また，施設職員の発言からは，プログラムによって対象者が社会参加の機会を得られたことや，本来対象者がもっている能力や資源が引き出されたことがうかがわれた．

結論：稲作を中心とした農業ケア・プログラムは，認知機能障害をもつ高齢者の社会参加を促し，精神的健康やうつを改善させるプログラムとして実行可能であることが確認できた．また，対象者が本来もっている能力や資源が引き出される可能性のあるプログラムでもある．今後は対象者の数を増やして，より質の高い研究デザインで効果を検証する必要がある．

【アブストラクト】
Objectives: Current research suggests that dementia care management (DCM) can decrease burden and associated health impairments of caregivers. The objective of this secondary analysis is to investigate the impact of DCM on multifaceted caregivers’ burden dimensions by differentiating between objective and subjective burden.

Methods: A sample of n = 317 dyads of caregivers and community-dwelling people with dementia (PwD) participated in a general practitioner-based, cluster-randomized intervention trial (Identifier:NCT01401582) with two arms and comprehensive data assessment at baseline and 12-month follow-up. Data provided by the caregiver included an inventory with 88 items in 20 different dimensions.

Results: Caregivers in the intervention ‘DCM’ group showed decreased caregiver burden, especially in caregivers’ objective burden due to caring (i.e. emotional support), caregivers’ subjective burden due to behavior change (i.e. cognition, aggression and resistance, depression, late symptoms) and caregivers’ subjective burden due to perceived conflicts between needs and responsibilities to care (i.e. financial losses) compared to caregivers in the control ‘care as usual’ group, which showed significant increased caregiver burden after 12 months.

Conclusion: Our findings support evidence for the effectiveness of DCM to lower family dementia caregivers' burden in multifaceted dimensions.

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Objectives: Little is understood about the optimal way to implement digital life story work (LSW). The aim of this research was to explore the preferences of people with dementia and caregivers in relation to digital LSW in an effort to improve future engagement.

Methods: 67 caregivers responded to an online discrete choice experiment (DCE) survey containing 16 pairwise choices. The DCE was analysed using a random effects logit model. Willingness to pay and odds ratios were also calculated. 17 participants with dementia completed an online survey in which they made choices about different aspects of digital LSW services.

Results: Caregivers valued four out of five attributes [setting (p = 0.000), price (p = 0.000), elementary usability and accessibility (p = 0.001), and follow-up assistance (p = 0.034)]. In data from participants with dementia, the most preferred setting was individual one-to-one (70.6%), and the most preferred use of digital life storybooks was to share memories with others (64.7%). Marginally more participants with dementia said they would pay for the service (53%) rather than only use it free of charge (47%). Those with advanced ICT skills preferred to learn how to use the digital life storybook (64.7%), while those with elementary/intermediate skills, preferred to have it created for them (35.3%).

Conclusions: This exploratory study provides an insight into preferences of people with dementia and caregivers, of how digital LSW is implemented. Results can contribute to future planning and tailoring of these services."

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This study evaluates whether an arts-based intergenerational experience, Opening Minds through Art (OMA), increases positive attitudes or allophilia (“liking for the other”—in this case, older adults with dementia) in students who joined the OMA program as compared with the control group. Pre- and posttests of the Allophilia Scale were used to compare 216 students who participated in OMA and 499 students who did not. Hierarchical regression was used to investigate the association between OMA participation and students’ Allophilia scores. After one semester, results showed that OMA participation is significantly positively associated with students’ affection, comfort, kinship, engagement, and enthusiasm toward older adults living with dementia. We conclude that increasing students’ allophilia toward older adults living with dementia is necessary and possible through well-designed intergenerational experiences.

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Nearly 50 million people worldwide are living with dementia. Communication difficulties linked to this illness demand that all healthcare professionals are prepared to meet the needs of this group of service users. In response to this, the United Kingdom government is calling for professionals to acquire a basic (Tier 1) Dementia Awareness (DA) qualification. As healthcare students need to engage in interprofessional learning (IPL), this report describes the development, implementation and evaluation of an initiative to link the DA qualification to an existing IPL module delivered to first-year healthcare students (IPL1). A DA learning package was developed by a group of educators from a range of professions to ensure an interprofessional focus. It comprised of a set of practical exercises that students completed during and after IPL1. Sixty students evaluated the DA learning package by completing a post-intervention survey. 57 students rated it helpful or very helpful, in enhancing their knowledge of how to care for a person with dementia, while 3 students rated it as average. Two themes emerged from open-ended questions, which highlighted the importance of: i) learning to work together; and ii) blended learning. Students also suggested some changes for the full roll out, such as moving the Dementia Friends component into IPL1. This is an innovative approach that can be used to meet the challenges linked with the large-scale preparation of our future workforce and to ensure purposeful IPL.

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This article considers the recent history and consequences of positioning people living with dementia in the realms of disability, disablism and disability rights. The geo-political focus is the United Kingdom and neighbouring resource-rich nations in the Global North. The first section examines the growing trend of identifying ‘dementia’ with ‘disability’, a trend fuelled by the expansion of dementia-related activism and research. The second section focuses on how researchers who have published in Disability & Society and other journals have applied the social model of disability to individuals living with dementia. The third section discusses three conceptual challenges that lie ahead for those who choose to research and theorise the dementia/disability connection. These challenges concern: theorising dementia as disability; understanding intersectionality in dementia contexts; and understanding ‘abuse’ in dementia contexts.