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認知症予防研究所

もの忘れと認知症の違い

年齢によって人の名前が思い出せなくなったり、忘れっぽくなったりするのは脳の老化が原因ですが、そうした誰にでも起きる現象ではなく、正常に知能が発達していたのに、何らかの原因で脳の神経細胞が壊れて、病的に脳の機能が低下することで記憶や判断力が低下し、時には人格の変化もともなって日常生活に支障をきたすようになった状態を認知症と呼びます。かつては痴呆(ちほう)と呼ばれていましたが、2004年に厚生労働省の用語検討会の報告に従って認知症に変えられました。統合失調症などに伴った判断力の低下や外傷による機能低下は認知症とは呼びません。

一般的に、老化による物忘れの場合は、忘れるのが部分的で、忘れっぽいことを自覚していて判断力には問題がありません。ヒントを与えると思い出し、時間や場所についてはしっかりと覚えています。そして、こうした物忘れはあまり進行もせず日常生活に問題もありません。これとは違って、認知症の場合は、体験したものごとについて全体的に記憶がなくなり、忘れたことの自覚もなく、判断力が低下して、時間とともに症状が悪化し、日常生活が困難になります。

現在、65歳以上の高齢者の中で認知症の人はおよそ15%で、2012年で462万人に上ることが厚生労働省の調査で明らかになっています。認知症の前段階である軽度認知障害(MCI)の高齢者も約400万人いると推計されており、実に65歳以上の4人に1人が認知症と予備軍になっています。さらに、2015年1月に厚生労働省が発表した推計によると、2025年の認知症患者は、現状の約1.5倍となる700万人を超える見込みです。MCI患者数を加えたら約1,300万人となり、65歳以上の3人に1人が認知症と、その予備軍となると予測されています。また、認知症の割合は年齢が上がるほど上昇し、85歳以上では4割を超え、90歳以上では6割に達しています。この年代では、ほぼ2人に1人が認知症なのです。

認知症には中核症状と周辺症状とよばれるものがあります。中核症状で代表的なものは記憶障害で、記憶ができないので直前に起こったことが思い出せなくなります。脳が正常だった頃の過去の記憶は残りますが、進行するにつれてそれもなくなっていきます。他に時間や場所を正しく認識できない見当識障害もあります。一方、周辺症状とは、中核症状に環境や本人の性格といった要因が作用して起こるもので、妄想や幻覚、暴力をふったり徘徊をしたりということがあります。また、うつや不安感、無気力といった状態にもなります。周辺症状は、最近では行動・心理症状(BPSD)と呼ばれます。

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