Department of Psychiatry Ludwig-Maximilians University, Munich, Germany.
J Alzheimers Dis. 2011;25(4):679-94. doi: 10.3233/JAD-2011-100999.
Recent studies have shown that patients with Alzheimer's disease (AD) and its possible prodromal stage mild cognitive impairment benefit from cognitive interventions. Few studies so far have used an active control condition and determined effects in different stages of disease. We evaluated a newly developed 6-month group-based multicomponent cognitive intervention in a randomized controlled pilot study on subjects with amnestic mild cognitive impairment (aMCI) and mild AD patients. Forty-three subjects with aMCI and mild AD were recruited. Primary outcome measures were change in global cognitive function as determined by the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and the Mini Mental Status Examination (MMSE). Secondary outcomes were specific cognitive and psychopathological ratings. Thirty-nine patients were randomized to intervention groups (IGs: 12 aMCI, 8 AD) and active control groups (CGs: 12 aMCI, 7 AD). At the end of the study, we found significant improvements in the IG(MCI) compared to the CG(MCI) in the ADAS-cog (p = 0.02) and for the secondary endpoint Montgomery Asberg Depression Rating Scale (MADRS) (p < 0.01) Effects on the MMSE score showed a non-significant trend (p = 0.07). In AD patients, we found no significant effect of intervention on the primary outcome measures. In conclusion, these results suggest that participation in a 6-month cognitive intervention can improve cognitive and non-cognitive functions in aMCI subjects. In contrast, AD patients showed no significant benefit from intervention. The findings in this small sample support the use of the intervention in larger scales studies with an extended follow-up period to determine long-term effects.
最近的研究表明,阿尔茨海默病(AD)患者及其可能的前驱轻度认知障碍患者从认知干预中受益。到目前为止,很少有研究使用主动对照条件,并确定不同疾病阶段的效果。我们在一项随机对照试点研究中评估了一种新开发的基于群体的 6 个月多成分认知干预,该研究针对有遗忘型轻度认知障碍(aMCI)和轻度 AD 患者。招募了 43 名 aMCI 和轻度 AD 患者。主要结局测量指标是阿尔茨海默病评估量表认知子量表(ADAS-cog)和简易精神状态检查(MMSE)测定的整体认知功能变化。次要结局是特定的认知和心理病理评定。39 名患者被随机分配到干预组(IG:12 名 aMCI,8 名 AD)和活性对照组(CG:12 名 aMCI,7 名 AD)。在研究结束时,我们发现与 CG(MCI)相比,IG(MCI)在 ADAS-cog 方面有显著改善(p = 0.02),次要终点蒙哥马利抑郁评定量表(MADRS)也有显著改善(p < 0.01)。MMSE 评分的影响呈非显著趋势(p = 0.07)。在 AD 患者中,我们没有发现干预对主要结局测量有显著影响。总之,这些结果表明,参加 6 个月的认知干预可以改善 aMCI 患者的认知和非认知功能。相比之下,AD 患者从干预中没有明显获益。在这个小样本中发现的结果支持在更大规模的研究中使用该干预措施,并延长随访期以确定长期效果。