Skjerve Arvid, Bjorvatn Bjørn, Holsten Fred
Department of Clinical Psychology, University of Bergen, Norway.
Int J Geriatr Psychiatry. 2004 Jun;19(6):516-22. doi: 10.1002/gps.1087.
To review literature concerning the efficacy, clinical practicability and safety of light treatment for behavioural and psychological symptoms of dementia (BPSD).
Data collection included computer literature searches (MEDLINE, PsycINFO and Cochrane) and checks of references, covering the period of January 1980-September 2003. Trials were searched for evidence for treatment efficacy and for their consideration of the treatment's clinical practicability and evidence of adverse effects.
Results from randomised controlled trials (RCT) indicated some evidence of improvement in aspects of sleep disturbances and circadian activity rhythmicity. One RCT study indicated better response in patients with vascular dementia compared to Alzheimer's disease. By and large, non-RCT studies reported improvement in BPSD including sleep disturbances, agitation and activity rhythm disturbances. Few studies commented on the treatment's practicability and safety.
Although there is some evidence for influence of light therapy on sleep and circadian activity rhythmicity, it is not possible to draw any conclusion about efficacy of light therapy for BPSD, or about practicability in clinical settings and safety. There are still too few well designed studies. Suggestions for further research are presented.
回顾关于光照疗法治疗痴呆行为和心理症状(BPSD)的疗效、临床实用性及安全性的文献。
数据收集包括计算机文献检索(MEDLINE、PsycINFO和Cochrane)以及参考文献核对,涵盖1980年1月至2003年9月期间。检索试验以获取治疗疗效的证据,以及对治疗临床实用性的考量和不良反应的证据。
随机对照试验(RCT)结果表明,在睡眠障碍和昼夜活动节律方面有一些改善的证据。一项RCT研究表明,与阿尔茨海默病患者相比,血管性痴呆患者的反应更好。总体而言,非RCT研究报告BPSD包括睡眠障碍、激越和活动节律障碍有所改善。很少有研究评论该治疗的实用性和安全性。
尽管有一些证据表明光照疗法对睡眠和昼夜活动节律有影响,但无法就光照疗法对BPSD的疗效、临床环境中的实用性和安全性得出任何结论。设计良好的研究仍然太少。提出了进一步研究的建议。