a Division of Psychiatry and Applied Psychology , University of Nottingham , Nottingham , United Kingdom.
b Division of Psychology and Language Sciences , University College London , London , United Kingdom.
Aging Ment Health. 2019 Apr;23(4):393-403. doi: 10.1080/13607863.2017.1423031. Epub 2018 Jan 17.
Over the last 10 years there has been a multitude of studies of psychosocial interventions for people with dementia. However, clinical services face a dilemma about which intervention should be introduced into clinical practice because of the inconsistency in some of the findings between different studies and the differences in the study qualities and trustworthiness of evidence. There was a need to provide a comprehensive summary of the best evidence to illustrate what works.
A review of the systematic reviews of psychosocial interventions in dementia published between January 2010 and February 2016 was conducted.
Twenty-two reviews (8 physical, 7 cognitive, 1 physical/cognitive and 6 other psychosocial interventions) with a total of 197 unique studies met the inclusion criteria. Both medium to longer-term multi-component exercise of moderate to high intensity, and, group cognitive stimulation consistently show benefits. There is not sufficient evidence to determine whether psychological or social interventions might improve either mood or behaviour due to the heterogeneity of the studies and interventions included in the reviews.
There is good evidence that multi-component exercise with sufficient intensity improves global physical and cognitive functions and activities of daily living skills. There is also good evidence that group-based cognitive stimulation improves cognitive functions, social interaction and quality of life. This synthesis also highlights the potential importance of group activities to improve social integration for people with dementia. Future research should investigate longer-term specific outcomes, consider the severity and types of dementia, and investigate mechanisms of change.
在过去的 10 年中，针对痴呆症患者的心理社会干预措施进行了大量研究。然而，由于不同研究之间的一些发现存在不一致性，以及研究质量和证据可信度存在差异，临床服务面临着一个困境，即应该引入哪种干预措施进入临床实践。因此，需要提供最佳证据的综合总结，以说明哪些干预措施有效。
对 2010 年 1 月至 2016 年 2 月期间发表的关于痴呆症心理社会干预的系统评价进行了综述。
共纳入 22 篇综述（8 篇为身体干预，7 篇为认知干预，1 篇为身体/认知干预，6 篇为其他心理社会干预），其中包含 197 项独特的研究。中等到长期、中等至高强度的多组分运动以及小组认知刺激均显示出获益。由于纳入的研究和干预措施存在异质性，无法确定心理或社会干预是否可能改善情绪或行为。
有充分的证据表明，具有足够强度的多组分运动可以改善整体身体和认知功能以及日常生活活动能力。基于小组的认知刺激也可以改善认知功能、社会互动和生活质量。这项综合研究还强调了小组活动对改善痴呆症患者社会融合的潜在重要性。未来的研究应该调查更长期的特定结局，考虑痴呆症的严重程度和类型，并研究干预措施的作用机制。
