Department of Medical Psychology, Alzheimer Centre Nijmegen, Radboud University Nijmegen Medical Centre, The Netherlands. l.joosten @ mps.umcn.nl
Gerontology. 2011;57(5):444-54. doi: 10.1159/000315933. Epub 2010 Jul 20.
Patients with mild cognitive impairment (MCI) have to deal with an uncertain prognosis and also face a multitude of memory-related problems and psychosocial consequences. A newly developed group programme proved to be feasible, however, it needed confirmation by a controlled study.
This controlled study evaluates this group therapy for MCI patients aimed to help them accept and manage the memory problems and the psychosocial consequences. The programme combines elements from psychoeducation, cognitive rehabilitation and cognitive-behavioural therapy.
Ninety-three MCI patients received treatment, with 30 patients being first assigned to a waiting list, thus serving as their own control group. Pre- and post-treatment acceptance and helplessness were assessed using subscales of the Illness Cognition Questionnaire, while distress and general well-being were gauged with the Geriatric Depression Scale and subscales of the RAND-36.
Linear mixed model analyses showed that, relative to the controls, acceptance had increased more in the intervention group compared to the waiting-list period (p = 0.034). Distress and general well-being showed no changes. Treatment responders demonstrating a clinically significant effect on acceptance and two of three secondary outcome measures had higher baseline levels of helplessness and fewer self-reported memory complaints in daily life than patients who did not improve.
The intervention helped the patients deal better with their uncertain future in that they were overall better able to accept their condition, with especially the female patients showing a decrease in helplessness cognitions, although the effects were relatively small.
轻度认知障碍（MCI）患者必须应对不确定的预后，同时还面临着许多与记忆相关的问题和心理社会后果。一个新开发的团体方案已被证明是可行的，但需要通过对照研究加以证实。
本对照研究评估了针对 MCI 患者的这种团体治疗，旨在帮助他们接受和管理记忆问题和心理社会后果。该方案结合了心理教育、认知康复和认知行为疗法的元素。
93 名 MCI 患者接受了治疗，其中 30 名患者首先被分配到等待名单上，作为他们自己的对照组。使用疾病认知问卷的子量表评估治疗前后的接受度和无助感，使用老年抑郁量表和 RAND-36 的子量表评估痛苦和一般幸福感。
线性混合模型分析显示，与对照组相比，干预组在干预期间比等待期更能增加接受度（p = 0.034）。痛苦和一般幸福感没有变化。治疗反应者在接受度和三个次要结果指标中的两个方面表现出临床显著的效果，与没有改善的患者相比，他们的无助感基线水平更高，日常生活中自我报告的记忆问题更少。
干预措施帮助患者更好地应对不确定的未来，因为他们总体上能够更好地接受自己的病情，特别是女性患者的无助认知有所下降，尽管效果相对较小。
