Nocon M, Roll S, Schwarzbach C, Vauth C, Greiner W, Willich S N
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité-Universitätsmedizin Berlin, Berlin, Deutschland.
Z Gerontol Geriatr. 2010 Jun;43(3):183-9. doi: 10.1007/s00391-010-0109-6. Epub 2010 May 8.
Today there are approximately one million people with dementia in Germany. Because most forms of dementia cannot be cured the focus of treatment is to provide adequate care, aiming at the maintenance of cognitive functioning, the ability to perform everyday tasks and quality of life. Important approaches for dementia care are multisensory stimulation, validation, reality orientation and reminiscence therapy. However, the efficacy of these approaches is unclear.
A systematic review of the literature was performed. We included randomised controlled trials with at least 30 participants on the efficacy of multi-sensory stimulation, validation, reality orientation and reminiscence therapy for dementia. No restrictions were defined with regard to the endpoints under investigation.
A total of 14 studies with 1,513 patients could be included of which 5 studies assessed reminiscence therapy, 4 multi-sensory stimulation, 3 validation and 2 reality orientation. The studies analysed cognitive functioning, behavioural outcomes, psychological symptoms and quality of life. Most studies did not find significant differences between the intervention and the control group.
The studies conducted to date provide only little evidence for the efficacy of the approaches for dementia care considered in this review. However, only few methodologically robust studies could be identified for this review which highlights the need for more interventional studies.
目前德国约有100万痴呆症患者。由于大多数形式的痴呆症无法治愈,治疗重点是提供充分护理,目标是维持认知功能、日常任务执行能力和生活质量。痴呆症护理的重要方法包括多感官刺激、确认疗法、现实定向疗法和怀旧疗法。然而,这些方法的疗效尚不清楚。
对文献进行系统综述。我们纳入了至少有30名参与者的随机对照试验,以研究多感官刺激、确认疗法、现实定向疗法和怀旧疗法对痴呆症的疗效。对所研究的终点未作限制。
共纳入14项研究,涉及1513名患者,其中5项研究评估了怀旧疗法,4项评估了多感官刺激,3项评估了确认疗法,2项评估了现实定向疗法。这些研究分析了认知功能、行为结果、心理症状和生活质量。大多数研究未发现干预组与对照组之间存在显著差异。
迄今为止进行的研究仅为本次综述中所考虑的痴呆症护理方法的疗效提供了很少的证据。然而,本次综述仅能找到很少方法学严谨的研究,这凸显了开展更多干预性研究的必要性。