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치매란 대뇌 신경세포의 손상 등으로 단기, 장기 기억력, 사고력, 지남력, 이해력, 언어력, 계산능력, 학습능력, 인지능력과 고등정신기능 등이 지속적 본질적으로 상실되는 병을 말한다. 이 책은 그런 치매의 원인과 증상을 알아보고 치매를 예방하기 위한 생활습관과 인지치료 및 행동치료 등 구체적이고 실천적인 방법들을 제시하고 있다.

머리말 ································································································································3

목 차 ································································································································5

제1장 치매란 무엇인가? ····························································································9
1. 치매의 개념 ·······································································································11
2, 치매의 실태 ·······································································································13
3. 치매의 위험인자 ································································································16
4. 치매의 진행단계 ································································································18
5. 치매와 유사한 증상 ···························································································21

제2장 치매의 문제점 ·······························································································25
1. 본인의 고통 ·······································································································27
2, 가족의 고통 ·······································································································28
3. 국가 부담 증가 ··································································································30

제3장 치매의 증상 ··································································································33
1. 인지기능 장애 ····································································································35
2. 언어적 장애 ·······································································································40
3. 신체적 장애 ·······································································································41
4. 정서적 장애 ·······································································································42
5. 행동 장애 ···········································································································44

제4장 치매의 종류 ··································································································45
1. 알츠하이머 질환 ································································································47
2. 혈관성 치매 ·······································································································49
3. 파킨슨병 ·············································································································51
4. 루이소체병 ··································································································52
5. 피크병 ··································································································53
6. 크로이트펠트 야콥병 ··································································································54
7. 헌팅톤병 ··································································································55
8. 기타 치매 ··································································································55

제5장 뇌의 구조와 치매 ··································································································57
1. 뇌의 구조 ··································································································59
2. 뇌의 발달 과정 ··································································································64
3. 전두엽의 기능 ··································································································68
4. 두정엽의 기능 ··································································································69
5. 측두엽의 기능 ··································································································70
6. 후두엽의 기능 ··································································································71
7. 변연계의 기능 ··································································································72

제6장 치매 관련 정책 및 복지서비스 ··································································································75
1. 치매 국가 책임제 ··································································································77
2. 치매 노인 공공후견제도 ··································································································78
3. 노인 장기요양보험제도 ··································································································79
4. 주간보호소 ··································································································84
5. 단기 보호시설 ··································································································87
6. 노인 장기요양기관 ··································································································89
7. 중앙치매센터와 권역치매센터 ··································································································91
8. 치매상담 콜센터 ··································································································95
9. 기타 ··································································································98

제7장 치매치료와 관리 ··································································································99
1. 치매의 약물 치료 ··································································································101
2. 치매의 비약물 치료 ··································································································103
3. 치매예방을 위한 식습관 ··································································································105
4. 치매예방을 위한 생활습관 ··································································································108
5. 치매노인을 위한 간병 ··································································································113
6. 치매환자의 문제행동 대처법 ··································································································116
7. 치매환자를 위한 환경관리 ··································································································119

제8장 노인에 대한 이해 ·······················································································121
1. 노인의 정의 ·····································································································123
2. 노인 인구의 추이 ····························································································126
3. 노인의 일반적 특징 ························································································128
4. 노화의 증상 ·····································································································131

제9장 치매예방 방법 ·····························································································135
1. 치매예방을 위한 인지요법 ··············································································137
2. 치매예방을 위한 활동지 활용 방법 ·······························································139
3. 치매예방을 위한 미술치료 ··············································································142
4. 치매예방을 위한 웃음치료 ··············································································145
5. 치매예방을 위한 음악치료 ··············································································147
6. 치매예방을 위한 독서치료 ··············································································149
7. 치매예방을 위한 동물매개치료 ·······································································151
8. 치매예방을 위한 이야기치료 ··········································································153
9. 치매예방을 위한 글쓰기치료 ··········································································155
10. 치매예방을 위한 시치료 ·················································································157
11. 치매예방을 위한 요리치료 ··············································································159

제10장 치매의 진단과 검사 ···············································································163
1. 치매선별용 한국형 간이정신상태 검사 ···························································165
2. 노인 우울성 검사 ··························································································173
3. 주관적 기억력 검사 ························································································176

제11장 치매예방을 위한 운동 ··············································································179
1. 노인에게 필요한 체력 ·····················································································181
2. 운동요법 ··········································································································184
3. 치매예방에 좋은 유산소 운동 ········································································186
4. 치매예방을 위한 스트레칭 ··············································································190
5. 치매예방을 위한 유연성 운동 ········································································192
6. 근력 강화를 위한 아령 운동 ··········································································196
7. 치매예방을 위한 박수 ·····················································································199
8. 말기 치매환자의 운동방법 ··············································································204

부록 ························································································································207
1. 치매선별용 한국형 간이정신 상태검사(SMMSE-DS) ··································209
2. 간이형 노인 우울증검사(SGDS-K) ································································211
3. 주관적 기억력 평가 문항(SMCQ) ·································································212
4. 프로그램 평가서 ······························································································213
5. 치매예방 교육과정 ·····························································································214
6. 치매 관리법 ·····································································································216
7. 전국 치매센터 ·································································································226

참고 문헌 ······················································································································228

[머리말]
고령화가 점차 증가하는 추세인 우리나라는 통계청의 자료에 의하면 알츠하이머형 치매가 71.3%에 달하며 혈관성 치매는 16.9%, 그리고 기타 치매는 11.8%인 것으로 나타났다. 그중에서도 65세 이상 노인 인구의 25%가 넘는 것으로 밝혀져, 향후 치매환자의 급증에 따른 심각한 사회문제가 예상되고 있다.

치매란 대뇌 신경세포의 손상 등으로 단기ㆍ장기 기억력, 사고력, 지남력, 이해력, 언어력, 계산능력, 학습능력, 인지기능과 고등정신기능 등이 지속적ㆍ본질적으로 상실되는 병을 말한다. 치매는 한 가지가 아니라 여러 가지 원인으로 발병된 최종적인 결과나 상태를 말한다. 치매의 원인이 되는 질환으로는 내과, 신경과 및 정신과 질환 등 70여 종류가 있는 것으로 알려져 있다.

치매는 노인 인구 가운데 높은 유병률(지역 인구에 대한 일정한 환자 수의 비율)을 보이고 있는 무서운 질병이므로 예방과 치료를 빨리 해야 한다. 치매에 걸리면 치매노인뿐만 아니라 치매환자를 부양하고 있는 가족까지 황폐화시키는 무서운 질병이다. 최근 출생률 저하와 평균수명 증가 등으로 고령화 사회가 빠르게 진행됨으로써 노인 치매는 사회문제로 대두되고 있다. 특히 주로 가정에서 담당했던 치매노인 부양이 핵가족화로 인해 점차 공공부문으로 이전되고 있다. 따라서 치매노인에 대한 적극적인 대책이 국가적으로 중요한 정책 과제로 부상하고 있다.

더 큰 문제는 인간의 수명이 늘어나는 것에 비례하여 치매가 증가한다는 사실이다. 인간의 수명이 늘어난다는 것은 분명 축복이라고 할 수 있다. 그러나 빛이 있으면 그림자가 있듯이, 수명이 늘어나는 것이 꼭 좋지만은 않은 듯하다.
현대의학의 발전으로 인간의 평균 수명이 100세까지 늘어날 것으로 전망하고 있지만 증가한 신체의 수명만큼 사람의 뇌 기능을 유지하지 못한다는 점이다. 앞으로 과학의 발전으로 치매를 예방하는 약물이 나올지 모르나 지금까지는 한번 치매에 걸리면 완치가 어려운 것으로 알려져 있다. 그러므로 치매는 사전에 예방하는 것이 가장 효과적이라고 할 수 있다.

이 책은 치매의 원인과 증상을 알아보고, 치매를 예방하기 위한 생활습관과 인지치료 및 행동치료 등 구체적이고 실천적인 방법들을 제시하고 있다. 이 책을 통하여 치매에 대한 기본지식의 습득은 물론 치매에 대한 이해를 높여 치매예방에 도움이 되길 바란다.

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