Lowery David, Cerga-Pashoja Arlinda, Iliffe Steve, Thuné-Boyle Ingela, Griffin Mark, Lee James, Bailey Alex, Bhattacharya Rahul, Warner James
Central and North West London NHS Foundation Trust (CNWL), London, UK; Primary Care and Population Health, University College London (UCL), London, UK.
Int J Geriatr Psychiatry. 2014 Aug;29(8):819-27. doi: 10.1002/gps.4062. Epub 2013 Dec 11.
The objective of this study is to evaluate the effectiveness of a simple dyadic (person with dementia and their main carer) exercise regimen as a therapy for the behavioural and psychological symptoms of dementia.
A two arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored walking regimen designed to become progressively intensive and last between 20-30 min, at least five times per week).Community-dwelling individuals with ICD-10 confirmed dementia with the following: clinically significant behavioural and psychological symptoms, a carer willing and able to co-participate in the exercise regimen, and no physical conditions or symptoms that would preclude exercise participation were invited by mental health or primary care services into the study.
One hundred and thirty-one dyads were recruited to this study. There was no significant difference in Behavioural and Psychological Symptoms as measured by the Neuropsychiatric Inventory at week 12 between the group receiving the dyadic exercise regimen and those that did not (adjusted difference in means (intervention minus control) = -1.53, p = 0.6, 95% CI [-7.37, 4.32]). There was a significant between-group difference in caregiver's burden as measured by the Zarit Caregiver Burden Inventory at week 12 (OR = 0.18, p = 0.01, CI [0.05, 0.69]) favouring the exercise group.
This study found that regular simple exercise does not appear to improve the behavioural and psychological symptoms of dementia, but did seem to attenuate caregiver burden. Further study to improve exercise uptake are needed.
本研究的目的是评估一种简单的二元（痴呆症患者及其主要照料者）锻炼方案作为痴呆症行为和心理症状治疗方法的有效性。
一项双臂、实用、随机、对照、单盲、平行组试验，采用二元锻炼方案（个体化定制的步行方案，设计为逐渐强化，每次持续20 - 30分钟，每周至少五次）。心理健康或初级保健服务机构邀请社区居住的符合ICD - 10确诊痴呆症的个体参与研究，这些个体需具备以下条件：具有临床显著的行为和心理症状、有愿意且能够共同参与锻炼方案的照料者，并且没有会妨碍参与锻炼的身体状况或症状。
本研究招募了131对二元组。在第12周时，接受二元锻炼方案的组与未接受该方案的组相比，通过神经精神科问卷测量的行为和心理症状没有显著差异（调整后的均值差异（干预组减去对照组）=-1.53，p = 0.6，95%可信区间[-7.37, 4.32]）。在第12周时，通过 Zarit 照料者负担量表测量，照料者负担在组间存在显著差异（OR = 0.18，p = 0.01，可信区间[0.05, 0.69]），锻炼组更具优势。
本研究发现，定期进行的简单锻炼似乎并不能改善痴呆症的行为和心理症状，但似乎确实减轻了照料者的负担。需要进一步开展研究以提高锻炼的参与度。
