Jensen Lou, Padilla René
Lou Jensen, OTD, OTR/L, is Assistant Professor of Occupational Therapy, Creighton University, Omaha, NE;
René Padilla, PhD, OT/L, FAOTA, LMHP, is Vice Provost for Global Engagement and Associate Professor of Occupational Therapy, Creighton University, Omaha, NE.
Am J Occup Ther. 2017 Sep/Oct;71(5):7105180030p1-7105180030p10. doi: 10.5014/ajot.2017.027409.
This systematic review evaluated the effectiveness of environment-based interventions that address behavior, perception, and falls in the home and other settings for people with Alzheimer's disease (AD) and related major neurocognitive disorders (NCDs).
Database searches were limited to outcomes studies published in English in peer-reviewed journals between January 2006 and April 2014.
A total of 1,854 articles were initially identified, of which 42 met inclusion criteria.
Strong evidence indicates that person-centered approaches can improve behavior. Moderate evidence supports noise regulation, environmental design, unobtrusive visual barriers, and environmental relocation strategies to reduce problematic behaviors. Evidence is insufficient for the effectiveness of mealtime ambient music, bright light, proprioceptive input, wander gardens, optical strategies, and sensory devices in improving behavior or reducing wandering and falls. Although evidence supports many environment-based interventions used by occupational therapy practitioners to address behavior, perception, and falls in people with AD and related major NCDs, more studies are needed.
本系统评价评估了基于环境的干预措施对患有阿尔茨海默病（AD）及相关重度神经认知障碍（NCD）的人群在家庭和其他场所的行为、认知及跌倒方面的有效性。
数据库检索仅限于2006年1月至2014年4月间发表在同行评审期刊上的英文结局研究。
最初共识别出1854篇文章，其中42篇符合纳入标准。
有力证据表明，以患者为中心的方法可改善行为。中等证据支持噪音调节、环境设计、不显眼的视觉屏障及环境重新安置策略以减少问题行为。关于用餐时背景音乐、强光、本体感觉输入、漫步花园、光学策略及感觉装置在改善行为或减少徘徊及跌倒方面的有效性，证据不足。尽管证据支持职业治疗从业者用于解决AD及相关重度NCD患者行为、认知及跌倒问题的许多基于环境的干预措施，但仍需要更多研究。
