痴呆症的维持认知刺激疗法：单盲、多中心、实用随机对照试验。
Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial.
机构信息
Martin Orrell, PhD, Elisa Aguirre, PhD, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Aimee Spector, PhD, Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford, and Research Department of Clinical, Educational and Health Psychology, University College London; Zoe Hoare, PhD, North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical & Social Care Research, Bangor; Robert T. Woods, MSc, DSDC Wales, Bangor University, Bangor; Amy Streater, MSc, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Helen Donovan, PsyD, Clinical Psychology Service, South Essex Partnership NHS Foundation Trust, Bedford; Juanita Hoe, PhD, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science; Christopher Whitaker, MSc, North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical & Social Care Research, Bangor; Ian Russell, PhD, Swansea University, College of Medicine, Singleton Park, Swansea, UK.
出版信息
Br J Psychiatry. 2014 Jun;204(6):454-61. doi: 10.1192/bjp.bp.113.137414. Epub 2014 Mar 27.
BACKGROUND
There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.
AIMS
To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).
METHOD
The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).
RESULTS
For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).
CONCLUSIONS
Continuing CST improves quality of life; and improves cognition for those taking AChEIs.
背景
有充分的证据表明短期认知刺激疗法对痴呆症有益，但对于其长期效果知之甚少。
目的
在一项单盲、实用随机对照试验中评估维持性认知刺激疗法（CST）对痴呆症患者的有效性，该试验包括一项亚组研究，其中包括服用乙酰胆碱酯酶抑制剂（AChEIs）的参与者。
方法
参与者为来自 9 家养老院和 9 家社区服务机构的 236 名痴呆症患者。在随机分组之前，所有参与者都接受了为期 7 周、14 节的 CST 方案。干预组接受了为期 24 周的每周维持性 CST 团体方案。对照组接受常规护理。主要结局指标为认知和生活质量（临床试验注册：ISRCTN26286067）。
结果
在 6 个月的主要终点，干预组的自我报告生活质量有显著改善（阿尔茨海默病生活质量量表（QoL-AD）P = 0.03）。在 3 个月时，代理报告的生活质量（QoL-AD P = 0.01，DEMQOL 量表 P = 0.03）和日常生活活动能力（P = 0.04）也有所改善。服用 AChEIs 的干预亚组在 3 个月（P = 0.03）和 6 个月（P = 0.03）时认知能力有改善。
结论
继续进行 CST 可提高生活质量；并改善服用 AChEIs 的患者的认知能力。
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