Vilela Vitória Carvalho, Pacheco Rafael Leite, Latorraca Carolina Oliveira Cruz, Pachito Daniela Vianna, Riera Rachel
Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
Master and Psychologist, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
Sao Paulo Med J. 2017 May-Jun;135(3):309-320. doi: 10.1590/1516-3180.2017.0092060617.
: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia.
: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo.
: Cochrane reviews on non-pharmacological interventions for cognitive dysfunctions and/or type of dementia were included. For this, independent assessments were made by two authors.
: Twenty-four reviews were included. These showed that carbohydrate intake and validation therapy may be beneficial for cognitive disorders. For dementia, there is a potential benefit from physical activity programs, cognitive training, psychological treatments, aromatherapy, light therapy, cognitive rehabilitation, cognitive stimulation, hyperbaric oxygen therapy in association with donepezil, functional analysis, reminiscence therapy, transcutaneous electrical stimulation, structured decision-making on feeding options, case management approaches, interventions by non-specialist healthcare workers and specialized care units. No benefits were found in relation to enteral tube feeding, acupuncture, Snoezelen stimulation, respite care, palliative care team and interventions to prevent wandering behavior.
: Many non-pharmacological interventions for patients with cognitive impairment and dementia have been studied and potential benefits have been shown. However, the strength of evidence derived from these studies was considered low overall, due to the methodological limitations of the primary studies.
痴呆症在全球范围内极为普遍。其慢性和进行性表现会对身体和心理社会特征以及公共医疗保健产生影响。我们的目的是总结Cochrane系统评价中关于认知障碍和痴呆症非药物治疗的证据。
在圣保罗联邦大学保罗医科大学循证医学学科进行的系统评价综述。
纳入Cochrane关于认知功能障碍和/或痴呆症类型的非药物干预的系统评价。为此，由两位作者进行独立评估。
纳入了24篇系统评价。这些结果表明，碳水化合物摄入和验证疗法可能对认知障碍有益。对于痴呆症，体育活动计划、认知训练、心理治疗、芳香疗法、光照疗法、认知康复、认知刺激、与多奈哌齐联合的高压氧疗法、功能分析、回忆疗法、经皮电刺激、喂养选择的结构化决策、病例管理方法、非专科医护人员的干预以及专科护理单元可能有益。在肠内管饲、针灸、Snoezelen刺激、临时护理、姑息治疗团队以及预防游荡行为的干预方面未发现益处。
已经对许多针对认知障碍和痴呆症患者的非药物干预措施进行了研究，并显示出潜在益处。然而，由于原始研究的方法学局限性，这些研究得出的证据总体强度被认为较低。
