Hindle John V, Watermeyer Tamlyn J, Roberts Julie, Brand Andrew, Hoare Zoe, Martyr Anthony, Clare Linda
Department of Care for the Elderly, Betsi Cadwaladr University Health Board, Llandudno, UK and School of Psychology, Bangor University, Bangor, UK.
Centre for Dementia Prevention, University of Edinburgh, Edinburgh, Scotland, UK.
Int J Geriatr Psychiatry. 2018 May;33(5):718-728. doi: 10.1002/gps.4845. Epub 2018 Jan 4.
To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study.
This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9). Primary outcomes were ratings of goal attainment and satisfaction with goal attainment. Secondary outcomes included quality of life, mood, cognition, health status, everyday functioning, and carers' ratings of goal attainment and their own quality of life and stress levels. Assessments were at 2 and 6 months following randomisation.
At 2 months, cognitive rehabilitation was superior to treatment-as-usual and relaxation therapy for the primary outcomes of self-rated goal attainment (d = 1.63 and d = 1.82, respectively) and self-rated satisfaction with goal attainment (d = 2.04 and d = 1.84). At 6 months, cognitive rehabilitation remained superior to treatment-as-usual (d = 1.36) and relaxation therapy (d = 1.77) for self-rated goal attainment. Cognitive rehabilitation was superior to treatment as usual and/or relaxation therapy in a number of secondary outcomes at 2 months (mood, self-efficacy, social domain of quality of life, carers' ratings of participants' goal attainment) and at 6 months (delayed recall, health status, quality of life, carer ratings of participants' goal attainment). Carers receiving cognitive rehabilitation reported better quality of life, health status, and lower stress than those allocated to treatment-as-usual.
Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson's disease.
在一项先导随机对照研究中，检验帕金森病相关痴呆患者认知康复的适宜性和可行性。
这是一项针对帕金森病相关痴呆的目标导向性认知康复的单盲先导随机对照试验。设定目标后，参与者被随机分为认知康复组（n = 10）、放松治疗组（n = 10）或常规治疗组（n = 9）。主要结局是目标达成的评分和对目标达成的满意度。次要结局包括生活质量、情绪、认知、健康状况、日常功能，以及护理人员对目标达成的评分及其自身的生活质量和压力水平。在随机分组后的2个月和6个月进行评估。
在2个月时，对于自评目标达成这一主要结局（效应量分别为1.63和1.82）以及自评目标达成满意度（效应量分别为2.04和1.84），认知康复优于常规治疗和放松治疗。在6个月时，对于自评目标达成，认知康复仍优于常规治疗（效应量为1.36）和放松治疗（效应量为1.77）。在2个月时（情绪、自我效能感、生活质量的社会领域、护理人员对参与者目标达成的评分）和6个月时（延迟回忆、健康状况、生活质量、护理人员对参与者目标达成的评分）的一些次要结局方面，认知康复优于常规治疗和/或放松治疗。接受认知康复的护理人员报告的生活质量、健康状况更好，压力更低，优于分配到常规治疗的护理人员。
认知康复对于帕金森病相关痴呆是可行且可能有效的。
