NeuroBioGen Lab-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Int J Geriatr Psychiatry. 2013 Jan;28(1):26-33. doi: 10.1002/gps.3785. Epub 2012 Feb 15.
The aim of the present study was to identify which factors may predict the best response to a comprehensive stimulation program in patients with dementia and mild cognitive impairment (MCI) as well as in their caregivers.
A six-month longitudinal study has been performed on 145 patients (55 with MCI and 90 with dementia), participating to a cognitive motor rehabilitation program, and their 131 caregivers, attending informational/psychoeducational interventions. Mini mental state examination, Alzheimer's Disease Assessment Scale-Cognition, and Clinician's Interview-Based Impression of Change-plus were used as primary outcome measures.
Sixty-eight (46.9%) of the 145 subjects were classified as clinical responders. At baseline, responders had a significant less insight impairment, larger functional ability as well as less delusions, euphoria, and aberrant motor behaviors than the non-responder. After 6 months along with an improvement in cognition, responders showed decrease in behavioral disturbances and severity of the disturbances. During the 6 months of analysis, stability has been observed in caregiver's burden distress. After 6 months, the caregivers of MCI responders have their burden reduced.
The high level of insight, the preserved functional abilities as well as the lack of severe delusions, euphoria, and aberrant motor behaviors are significant predictors of responsiveness to stimulation program.
本研究旨在确定哪些因素可能预测痴呆和轻度认知障碍（MCI）患者及其护理者对综合刺激计划的最佳反应。
对 145 名患者（55 名 MCI 和 90 名痴呆症）进行了为期 6 个月的纵向研究，他们参加了认知运动康复计划，其 131 名护理人员参加了信息/心理教育干预。采用简易精神状态检查、阿尔茨海默病评估量表-认知以及临床医生基于访谈的变化印象加分为主要结局指标。
145 名受试者中有 68 名（46.9%）被归类为临床反应者。在基线时，与非反应者相比，反应者的洞察力障碍较小，功能能力较大，妄想、欣快和异常运动行为较少。6 个月后，认知能力有所改善，反应者的行为障碍和严重程度有所下降。在分析的 6 个月期间，护理人员的负担困扰保持稳定。6 个月后，MCI 反应者的护理人员负担减轻。
高洞察力、功能能力完好以及无严重妄想、欣快和异常运动行为是对刺激计划反应的显著预测因素。
