De Vreese L P, Neri M, Fioravanti M, Belloi L, Zanetti O
Special Care Unit for Dementia Patients, Health Care Facility for Elderly, Via Paul Harris 165, 41100 Modena, Italy.
Int J Geriatr Psychiatry. 2001 Aug;16(8):794-809. doi: 10.1002/gps.428.
Memory rehabilitation is a sadly misrepresented area of applied research in Alzheimer's disease.
To gather and evaluate recent evidence for the clinical effectiveness or ecologically validity of memory rehabilitation for mild to moderate Alzheimer's patients.
Computerised searches and some handsearching were conducted spanning the last five years, from 1995 to 2000, inclusively. Criteria for inclusion in this overview involved the use of a precise memory rehabilitation technique within an experimental study design applied to Alzheimer's patients with pre- and post-treatment evaluation.
Three potential levels of memory rehabilitation procedures with proven clinical or pragmatic efficacy were identified. The first level bears on the facilitation of residual explicit memory with structured support both at encoding and at subsequent recall; the second level of memory rehabilitation exploits the relatively intact implicit memory system (priming and procedural memory); the last deals with finding ways of coping with the patient's limited explicit memory capacities through the use of external memory aids. A proposal of suggestions for good practice and future research in memory rehabilitation is also offered with the hope to spur further development in this rapidly expanding area of applied research.
The available evidence shows that alternative and innovative ways of memory rehabilitation for Alzheimer's patients can indeed be clinically effective or pragmatically useful with a great potential for use within the new culture of a more graded and proactive type of Alzheimer's disease care.
在阿尔茨海默病的应用研究领域，记忆康复是一个令人遗憾地被误解的领域。
收集并评估近期关于轻度至中度阿尔茨海默病患者记忆康复的临床有效性或生态效度的证据。
进行了计算机检索，并辅以一些手工检索，时间跨度为1995年至2000年这五年（含起止年份）。纳入本综述的标准包括在一项实验性研究设计中使用精确的记忆康复技术，该设计应用于有治疗前和治疗后评估的阿尔茨海默病患者。
确定了三种具有已证实的临床或实际疗效的记忆康复程序潜在水平。第一个水平涉及在编码和随后的回忆时通过结构化支持促进残余的外显记忆；第二个水平的记忆康复利用相对完整的内隐记忆系统（启动效应和程序性记忆）；最后一个涉及通过使用外部记忆辅助工具来寻找应对患者有限外显记忆能力的方法。还提出了关于记忆康复良好实践和未来研究的建议，希望能推动这一迅速发展的应用研究领域的进一步发展。
现有证据表明，针对阿尔茨海默病患者的替代性和创新性记忆康复方法在临床上确实有效或具有实际用途，在更分级和积极主动的阿尔茨海默病护理新文化中具有很大的应用潜力。
