Cicconetti P, Fionda A, Zannino G, Ettorre E, Marigliano V
Cattedra di Geriatria e Gerontologia, Università La Sapienza, Roma.
Recenti Prog Med. 2000 Sep;91(9):450-4.
Alzheimer's disease is a neurodegenerative disease that causes a progressive decline of cognitive and behavioural functions. The simultaneous presence of these disorders requires a treatment not only for cognitive decline, but also for behavioural symptoms, depression and caregiver's stress. Research has made many efforts to develop a wide range of treatments, different from current pharmacological therapy, which is not resolutive, owing to the absence of an exact etiopathogenetic mechanism. Since new drugs have not been shown to be really effective in slowing cognitive impairment, various forms of rehabilitative interventions have been proposed in order to treat Alzheimer's disease. Their efficacy in the improvement of cognitive functions is still not completely clear. Surely, interesting results have been obtained from studies about Reality Orientation Therapy, Occupational Therapy and Memory Training. Music therapy might provide a new form of rehabilitative intervention, especially acting on the reducing of behavioural symptoms. These alternative forms of non pharmacological treatment may have a positive effect on caregiver. The heavy emotional burden of seeing a loved one becoming confused and isolated and of having to accept new responsibilities, may be reduced by rehabilitative supports, complementary to the pharmacological therapy. Caregiver stress could be reduced in two ways: by promoting the hope that something is being done for the patient and providing free time for himself.
阿尔茨海默病是一种神经退行性疾病，会导致认知和行为功能逐渐衰退。这些障碍的同时存在不仅需要针对认知衰退进行治疗，还需要针对行为症状、抑郁和照料者压力进行治疗。由于缺乏确切的病因发病机制，目前的药物治疗效果不佳，因此研究人员付出了诸多努力来开发多种不同的治疗方法。由于尚未证明新药在减缓认知障碍方面真正有效，所以人们提出了各种形式的康复干预措施来治疗阿尔茨海默病。其在改善认知功能方面的疗效仍不完全清楚。当然，关于现实定向疗法、职业疗法和记忆训练的研究已经取得了有趣的成果。音乐疗法可能提供一种新的康复干预形式，特别是在减轻行为症状方面发挥作用。这些非药物治疗的替代形式可能对照料者有积极影响。看到亲人变得困惑和孤立以及不得不承担新责任所带来的沉重情感负担，可能会通过与药物治疗相辅相成的康复支持而减轻。照料者的压力可以通过两种方式减轻：一是让他们看到正在为患者采取措施从而燃起希望，二是为他们提供属于自己的空闲时间。
