智能障礙者罹患失智症風險：機構照顧者認知識能分析

Risk of Dementia in People with Intellectual Disabilieites: An Analysis of Institutional Caregivers’Cognitive Literacy Skills

智能障礙者被認為有提早老化現象與很高的罹患失智症風險。此外，因其本身智力缺陷與認知能力之限制，導致其失智症徵候或所受之影響常無法清楚明確的表達，須仰賴照顧者的觀察加以發現，因此照顧者對失智症的識能顯得重要。本研究目的乃調查照顧者對智能障礙者罹患失智症風險識能認知情形，該風險識能量表以Deb et al.（2007）發展的「智能障礙者失智症篩檢量表」（Dementia Screening Questionnaire for Individuals with Intellectual Disabilities, DSQIID）為架構進行問卷設計。研究以立意取樣選取6家身心障礙福利服務機構進行調查，該機構照顧者為研究對象進行資料收集，共完成369份有效問卷，回覆問卷以SPSS 26版進行統計分析。結果顯示機構照顧者對DSQIID所列智能障礙者罹患失智症風險識能-活動、認知、定向感、行為四個面向之間顯著相關，他們對這些風險特徵也有不錯的認知程度(80%以上)，但仍有幾項失智症風險特徵，例如：「需要他人協助進食」、「不敢走小裂縫、地上的線或不平坦的地面」、「要靠助行器才能獨立行走」、「遠離人群（例如：不喜歡人多的地方）」、「出現言語或肢體上的攻擊行為」、「有癲癇發作的情形」等，這些特徵是原來智能障礙者就有此情形，或是罹患失智症後之轉變，在照顧實務上可能較難以鑑別，這些失智症風險項目是未來值得檢視與利用該量表的識能教育重要議題。

People with intellectual disabilities are considered to have premature aging and a high risk of developing dementia. In addition, due to their own intellectual deficits and cognitive limitations, the symptoms of dementia or the effects of dementia often cannot be clearly expressed and must be detected by the caregiver's observation, so the caregiver's knowledge of dementia is important. The purpose of this study was to investigate the caregivers' perception of the risk of dementia among individuals with intellectual disabilities. The risk perception scale was designed based on the framework of the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID), which was developed by Deb et al. (2007). A total of 369 valid questionnaires were completed, and the responses were statistically analyzed using SPSS version 26. The results showed that there was a significant correlation between the DSQIID caregivers' perception of the risk of dementia - activity, cognition, orientation, and behavior - among the DSQIID scale. The respondent had a good level of awareness of these risk characteristics (more than 80%). However, there were still a few risk characteristics for dementia needed to evaluated carefully, such as: ''needing assistance in eating'', ''being afraid to walk on cracks, lines on the ground, or uneven surfaces'', ''depends on a walker to walk independently'', ''stays away from people (e.g., doesn't like crowded places)'', ''exhibits verbal or physical aggression'', and ''has epileptic seizures'', etc. Whether these characteristics are inherent in the original person with intellectual disability or are only developed after the person has suffered from dementia, it may be more difficult to identify currently. It is worthwhile to review the issues of literacy education using this scale in the future.