联合药物治疗和认知刺激疗法对阿尔茨海默病认知功能的短期影响。

Short-term effect of combined drug therapy and cognitive stimulation therapy on the cognitive function of Alzheimer's disease.

机构信息

Department of Clinical Psychology, Faculty of Educational Psychology, Tokyo Gakugei University, Koganei, Japan.

出版信息

Psychogeriatrics. 2010 Dec;10(4):167-72. doi: 10.1111/j.1479-8301.2010.00335.x.

DOI:10.1111/j.1479-8301.2010.00335.x

PMID:21159050

Abstract

BACKGROUND

Acetylcholinesterase inhibitors (i.e. donepezil) are known to benefit Alzheimer's disease (AD) patients. However, the combined effects of acetylcholinesterase and cognitive stimulation therapy (CST) are still debated. The present study examined their combined effects on the progression of cognitive decline in AD.

METHODS

The present study was a non-randomized controlled study and included two groups of patients with AD (i.e. CST group and control group). The CST group consisted of 31 patients with AD who received donepezil and weekly, 30-min CST sessions over the course of 7 weeks. The control group consisted of 18 patients who received only donepezil. Changes in cognitive abilities were assessed with Hasegawa's Dementia Scale-Revised (HDS-R) and were statistically analyzed by repeated-measure analysis of variance (anova).

RESULTS

ANOVA showed a significant group × time interaction effect on the HDS-R score. HDS-R scores for the CST group increased significantly during the intervention period, whereas the scores for the control group did not increase. Differences between the means of pre- and post-test HDS-R scores were significantly different between the groups; scores were significantly higher for the CST group than the control group. The groups differed significantly in the proportion of subjects whose score increased by more than four points on the HDS-R (Fisher's exact test, P < 0.05; 8 patients (25.8%) in the CST group and none (0.0%) in the control group).

CONCLUSIONS

These results suggest that CST is one of the important non-pharmacological treatment strategies for patients with AD.

摘要

背景

乙酰胆碱酯酶抑制剂（如多奈哌齐）已知对阿尔茨海默病（AD）患者有益。然而，乙酰胆碱酯酶和认知刺激疗法（CST）的联合作用仍存在争议。本研究旨在探讨它们联合应用对 AD 患者认知衰退进展的影响。

方法

本研究为非随机对照研究，纳入两组 AD 患者（即 CST 组和对照组）。CST 组由 31 例接受多奈哌齐和每周 30 分钟 CST 治疗 7 周的 AD 患者组成。对照组由 18 例仅接受多奈哌齐治疗的患者组成。采用长谷川痴呆量表修订版（HDS-R）评估认知能力变化，并采用重复测量方差分析（anova）进行统计学分析。

结果

anova 显示 HDS-R 评分的组×时间交互效应有统计学意义。CST 组在干预期间 HDS-R 评分显著增加，而对照组评分没有增加。组间 HDS-R 评分的预测试和后测试均值差异有统计学意义；CST 组的评分明显高于对照组。CST 组 HDS-R 评分增加超过 4 分的患者比例与对照组差异有统计学意义（Fisher 确切检验，P < 0.05；CST 组 8 例（25.8%），对照组无 1 例（0.0%））。