Huang Hui-Chuan, Chen Yu-Ting, Chen Pin-Yuan, Huey-Lan Hu Sophia, Liu Fang, Kuo Ying-Ling, Chiu Hsiao-Yean
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
School of Nursing, College of Medicine, Chung Gung University, Taoyuan, Taiwan.
J Am Med Dir Assoc. 2015 Dec;16(12):1087-94. doi: 10.1016/j.jamda.2015.07.010. Epub 2015 Sep 1.
Cognitive function impairments and depressive symptoms are common in elderly people with dementia. Previous meta-analyses of outdated and small-scale studies have reported inconsistent results regarding the effects of reminiscence therapy on cognitive functions and depressive symptoms; therefore, we conducted a meta-analysis by including more recent randomized controlled trials (RCTs) with large sample sizes to investigate the immediate and long-term (6-10 months) effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia.
Electronic databases, including PubMed, Medline, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, ProQuest, Google Scholar, and Chinese databases were searched to select eligible articles. Primary outcome measures included the scores of cognitive functions and depressive symptoms. In total, 12 RCT studies investigating the effects of reminiscence therapy on cognitive functions and depressive symptoms in elderly people with dementia were included. Two reviewers independently extracted data. All analyses were performed using a random-effects model.
Reminiscence therapy had a small-size effect on cognitive functions (g = 0.18, 95% confidence interval [CI] 0.05-0.30) and a moderate-size effect on depressive symptoms (g = -0.49, 95% CI -0.70 to -0.28) in elderly people with dementia. Long-term effects of reminiscence therapy on cognitive functions and depressive symptoms were not confirmed. Moderator analysis revealed that institutionalized elderly people with dementia exhibited greater improvement in depressive symptoms than community-dwelling people with dementia did (g = -0.59 vs. -0.16, P = .003).
This meta-analysis confirms that reminiscence therapy is effective in improving cognitive functions and depressive symptoms in elderly people with dementia. Our findings suggest that regular reminiscence therapy should be considered for inclusion as routine care for the improvement of cognitive functions and depressive symptoms in elderly people with dementia, particularly in institutionalized residents with dementia.
认知功能障碍和抑郁症状在老年痴呆患者中很常见。以往对过时的小规模研究进行的荟萃分析报告了关于回忆疗法对认知功能和抑郁症状影响的不一致结果;因此,我们通过纳入更多近期的大样本随机对照试验(RCT)进行荟萃分析,以研究回忆疗法对老年痴呆患者认知功能和抑郁症状的即时及长期(6 - 10个月)影响。
检索电子数据库,包括PubMed、Medline、CINAHL、PsycINFO、Cochrane对照试验中央注册库、ProQuest、谷歌学术以及中文数据库,以筛选符合条件的文章。主要结局指标包括认知功能和抑郁症状的评分。总共纳入了12项研究回忆疗法对老年痴呆患者认知功能和抑郁症状影响的RCT研究。两名评审员独立提取数据。所有分析均采用随机效应模型。
回忆疗法对老年痴呆患者的认知功能有小效应(g = 0.18,95%置信区间[CI] 0.05 - 0.30),对抑郁症状有中等效应(g = -0.49,95% CI -0.70至 -0.28)。未证实回忆疗法对认知功能和抑郁症状的长期影响。调节因素分析显示,与社区居住的老年痴呆患者相比,机构化的老年痴呆患者在抑郁症状方面改善更大(g = -0.59对 -0.16,P = 0.003)。
这项荟萃分析证实回忆疗法对改善老年痴呆患者的认知功能和抑郁症状有效。我们的研究结果表明,应考虑将定期回忆疗法纳入常规护理,以改善老年痴呆患者的认知功能和抑郁症状,特别是机构化居住的痴呆患者。