BRAIN and NERVE－神経研究の進歩74巻12号

2022年12月発行

特集 映画を観て精神・神経疾患を知る

映画にみる認知症

著者： 三村將¹

所属機関： ¹慶應義塾大学医学部精神神経科学教室

ページ範囲：P.1335 - P.1345

文献概要

映画は人の生きざまを描き出すための映像芸術の一手法である。人生は記憶に裏打ちされており，記憶喪失をはじめ，記憶障害をテーマとした映画は古今東西，枚挙にいとまがない。その中で認知症を扱った映画も多い。本稿では若年性レビー小体型認知症の人とその家族を描いた『妻の病 レビー小体型認知症』と，若年性アルツハイマー病の人とその家族を描いた『アリスのままで』という2作品を取り上げ，精神医学的観点から考察を試みた。前者の作品では幻覚妄想状態と視覚認知障害，また認知症の介護に焦点を当てた。後者の作品では認知症の語健忘，自己鏡像認知障害，自殺，そして告知の問題について私見を述べた。

参考文献

1）三村 將: 記憶の分類. Clin Neurosci 21: 799-802, 2003

2）Liu C, Liu S, Wang X, Ji Y: Neuropsychiatric profiles in mild cognitive impairment with Lewy bodies. Aging Ment Health 25: 2011-2017, 2021

3）Yamagata B, Kobayashi H, Yamamoto H, Mimura M: Visual text hallucinations of thoughts in an alexic woman. J Neurol Sci 339: 226-228, 2014

4）Kanemoto H, Sato S, Satake Y, Koizumi F, Taomoto D, et al: Impact of behavioral and psychological symptoms on caregiver burden in patients with dementia with Lewy bodies. Front Psychiatry 12: 753864, 2021［doi: 10.3389/fpsyt.2021.753864］

5）Sato H, Nakaaki S, Sato J, Shikimoto R, Furukawa TA, et al: Caregiver self-efficacy and associated factors among caregivers of patients with dementia with Lewy bodies and caregivers of patients with Alzheimer's disease. Psychogeriatrics 21: 783-794, 2021

6）Svendsboe E, Terum T, Testad I, Aarsland D, Ulstein I, et al: Caregiver burden in family carers of people with dementia with Lewy bodies and Alzheimer's disease. Int J Geriatr Psychiatry 31: 1075-1083, 2016

7）Ricci M, Guidoni SV, Sepe-Monti M, Bomboi G, Antonini G, et al: Clinical findings, functional abilities and caregiver distress in the early stage of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Arch Gerontol Geriatr 49: e101-e104, 2009［doi: 10.1016/j.archger.2008.10.001］

8）Lowery K, Mynt P, Aisbett J, Dixon T, O'Brien J, et al: Depression in the carers of dementia sufferers: a comparison of the carers of patients suffering from dementia with Lewy bodies and the carers of patients with Alzheimer's disease. J Affect Disord 59: 61-65, 2000

9）梅田 聡: 「ど忘れ」と「し忘れ」の認知神経メカニズム. 老年精医誌31: 143-148, 2020

10）Leyton CE, Hodges JR, Piguet O, Ballard KJ: Common and divergent neural correlates of anomia in amnestic and logopenic presentations of Alzheimer's disease. Cortex 86: 45-54, 2017

11）Alvargonzález D: Alzheimer's disease and euthanasia. J Aging Stud 26: 377-385, 2012

12）Braun B, Demling J, Loew TH: Alzheimer's disease: history, ethics and medical humanities in the context of assisted suicide. Philos Ethics Humanit Med 17: 4, 2022［doi: 10.1186/s13010-021-00111-z］

13）Portacolone E, Byers AL, Halpern J, Barnes DE: Addressing suicide risk in patients living with dementia during the COVID-19 pandemic and beyond. Gerontologist 62: 956-963, 2022

14）Eliasen A, Dalhoff KP, Horwitz H: Neurological diseases and risk of suicide attempt: a case-control study. J Neurol 265: 1303-1309, 2018

15）Serafini G, Calcagno P, Lester D, Girardi P, Amore M, et al: Suicide risk in Alzheimer's disease: a systematic review. Curr Alzheimer Res 13: 1083-1099, 2016

16）濱中淑彦: 自己の鏡像認知の問題. 臨床神経精神医学—意識・知能・記憶の病理. 医学書院, 東京, 1986, pp290-294

17）Prior H, Schwarz A, Güntürkün O: Mirror induced behavior in the magpie (Pica pica): evidence of self-recognition. PLoS Biol 6: e202, 2008［doi: 10.1371/journal.pbio.0060202］

18）Uchino E, Watanabe S: Self-recognition in pigeons revisited. J Exp Analysis Behav 102; 327-334, 2014

19）加藤弘美: 乳幼児における自己鏡像認知研究の近年の動向と今後の展望. 人間発達学研究3: 1-8 2012

20）Ajuriaguerra J, Strejilevitch M, Tissot R: A propos de quelques conduits devant le miroir de sujets atteints de syndromes dementiels du grand age. Neuropsychologia 1: 59-73, 1963

21）Funayama M, Nakagawa Y, Nakajima A, Takata T, Mimura Y, et al: Dementia trajectory for patients with logopenic variant primary progressive aphasia. Neurological Sciences 40: 2573-2579, 2019

22）Nagahama Y, Fukui T, Akutagawa H, Ohtaki H, Okabe M, et al: Prevalence and clinical implications of the mirror and TV signs in advanced Alzheimer's disease and dementia with Lewy bodies. Dement Geriatr Cogn Dis Extra 10: 56-62, 2020

23）Alzheimer's Association. 2015 Alzheimer's Disease Facts and Figures.　https://www.alz.org/facts/downloads/facts_figures_2015.pdf（2022年10月24日閲覧）

24）Holroyd S, Turnbull Q, Wolf AM: What are patients and their families told about the diagnosis of dementia? Results of a family survey. Int J Geriatr Psychiatry 17: 218-221, 2002

25）Jha A, Tabet N, Orrell M: To tell or not to tell: comparison of older patient's reaction to their diagnosis of dementia and depression. Int J Geriatr Psychiatry 16: 879-885, 2001

26）Umegaki H, Onishi J, Suzuki Y, Endo H, Iguchi A: Attitudes toward disclosing the diagnosis of dementia in Japan. Int Psychogeriatr 19: 253-265, 2007

27）今井幸充, 渡邉浩文: 認知症の病名告知とインフォームド・コンセント（IC）. 日認知症ケア会誌10: 421-428, 2012

28）Frank L, Lloyd A, Flynn JA, Kleinman L, Matza LS, et al: Impact of cognitive impairment on mild dementia patients and mild cognitive impairment patients and their informants. Int Psychogeriatr 18: 151-162, 2006

29）三村 將, 古田伸夫: 軽度認知障害への対応・訓練—説明と病名告知を含めて. 老年精神医誌20: 287-293, 2009

30）Lim YY, Maruff P, Getter C, Snyder PJ: Disclosure of positron emission tomography amyloid imaging results: a preliminary study of safety and tolerability. Alzheimers Dement 12: 454-458, 2016

31）Wake T, Tabuchi H, Funaki K, Ito D, Yamagata B, et al: The psychological impact of disclosing amyloid status to Japanese elderly: a preliminary study on asymptomatic patients with subjective cognitive decline. Int Psychogeriatrics, 30: 635-639, 2018

32）Wake T, Tabuchi H, Funaki K, Ito D, Yamagata B, et al: Disclosure of amyloid status for risk of Alzheimer disease to cognitively normal research participants with subjective cognitive decline: a longitudinal study. Am J Alzheimer Dis Other Dementia 35: 1-9, 2020