Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Alzheimer Dis Assoc Disord. 2012 Jul-Sep;26(3):246-53. doi: 10.1097/WAD.0b013e318231e46e.
Cognitive rehabilitation (CR) is a promising treatment approach for older adults with dementia because it aims at supporting the management of day-to-day problems. There is insufficient evidence regarding whether CR provides clinically meaningful benefits. In this study, we evaluated the feasibility, acceptance, efficacy, and usefulness of a CR intervention in a multicenter, randomized, controlled trial on 201 patients with mild dementia in Alzheimer disease and their carers. The intervention comprised 12 individual weekly sessions and combined 4 established strategies adopted from neurorehabilitation and psychotherapy. Activities of daily living were chosen as the primary outcome. The results show that the feasibility, treatment adherence, and carer commitment were excellent. However, no effect of the intervention was demonstrable on everyday functioning. There were improvements favoring the intervention on quality of life and treatment satisfaction and a significant antidepressant effect in female participants. The lack of impact on everyday activities may be due to methodological limitations including insufficient personalization, short treatment duration, poor transfer into the real-life setting, and low sensitivity of assessment instruments. The findings of this study may be helpful for designing further studies that are needed to determine the potential of CR in older adults with dementia.
认知康复（CR）是一种有前途的治疗老年痴呆症患者的方法，因为它旨在支持日常问题的管理。关于 CR 是否提供有临床意义的益处的证据不足。在这项研究中，我们评估了认知康复干预在一项针对 201 名轻度阿尔茨海默病痴呆症患者及其照顾者的多中心、随机、对照试验中的可行性、可接受性、疗效和有用性。该干预包括 12 次每周一次的个体治疗，结合了神经康复和心理治疗中采用的 4 种既定策略。日常生活活动被选为主要结局。结果表明，干预的可行性、治疗依从性和照顾者的承诺都非常出色。然而，干预对日常生活功能没有显示出效果。干预在生活质量和治疗满意度方面有改善，女性参与者有明显的抗抑郁作用。日常生活活动没有受到影响，可能是由于方法学限制，包括个性化不足、治疗时间短、在现实生活环境中的转移效果差以及评估工具的敏感性低。本研究的结果可能有助于设计进一步的研究，以确定认知康复对老年痴呆症患者的潜力。
