Fonte Cristina, Smania Nicola, Pedrinolla Anna, Munari Daniele, Gandolfi Marialuisa, Picelli Alessandro, Varalta Valentina, Benetti Maria V, Brugnera Annalisa, Federico Angela, Muti Ettore, Tamburin Stefano, Schena Federico, Venturelli Massimo
Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy.
Aging (Albany NY). 2019 May 24;11(10):3138-3155. doi: 10.18632/aging.101970.
Cognitive and physical activity treatments (CT and PT) are two non-pharmacological approaches frequently used in patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). The aim of this study was to compare CT and PT in these diseases. Eighty-seven patients were randomly assigned to CT (n=30), PT (n=27) or control group (CTRL; n=30) for 6 months. The global cognitive function was measured by Mini Mental State Examination (MMSE). Specific neuropsychological tests explored attention, memory, executive functions, behavioral disorders. Cardiovascular risk factors (CVD) were collected. All measures were performed before (T0), after treatments (T1), and at three-months follow-up (T2). MMSE did not change from T0 to T1 and T2 in patients assigned to PT and CT, while CTRL patients showed a decline MCI: -11.8%, AD: -16.2%). Between group differences (MCI vs AD) were not found at T1 and T2. Significant worsening was found for CTRL in MCI (T0- T1: =.039; T0-T2: <.001) and AD (T0-T1: <.001; T0-T2: <.001), and amelioration was found for CT in AD (T0-T2: <.001). Attention, executive functions and behavioral disorders were unaffected by either PT or CT. Memory was increased in patients with MCI assigned to PT (+6.9%) and CT (+8.5%).. CVD were ameliorated in the PT group. CTRL patients of both groups, revealed significant decline in all functions and no between groups differences were detected. PT appear to ameliorate CVD. Although between groups differences were not found, results suggest a major retention in MCI compared with AD, suggesting that the latter might benefit better of constant rather than periodic treatments. This study confirms the positive effects of CT and PT in mitigating the cognitive decline in MCI and AD patients, and it is the first to demonstrate their similar effectiveness on maintaining cognitive function.
认知和身体活动疗法（CT和PT）是轻度认知障碍（MCI）和阿尔茨海默病（AD）患者常用的两种非药物治疗方法。本研究的目的是比较这两种疾病中的CT和PT。87名患者被随机分为CT组（n = 30）、PT组（n = 27）或对照组（CTRL；n = 30），为期6个月。通过简易精神状态检查表（MMSE）测量整体认知功能。通过特定的神经心理学测试探究注意力、记忆力、执行功能、行为障碍。收集心血管危险因素（CVD）。所有测量均在治疗前（T0）、治疗后（T1）和三个月随访时（T2）进行。分配到PT和CT组的患者，MMSE从T0到T1和T2没有变化，而对照组患者出现下降（MCI组：-11.8%，AD组：-16.2%）。在T1和T2时未发现组间差异（MCI组与AD组）。对照组在MCI（T0 - T1：= 0.039；T0 - T2：< 0.001）和AD（T0 - T1：< 0.001；T0 - T2：< 0.001）中出现显著恶化，CT组在AD中出现改善（T0 - T2：< 0.001）。注意力、执行功能和行为障碍均未受PT或CT的影响。分配到PT组（+6.9%）和CT组（+8.5%）的MCI患者记忆力有所提高。PT组的CVD得到改善。两组的对照组患者，所有功能均出现显著下降，未检测到组间差异。PT似乎能改善CVD。虽然未发现组间差异，但结果表明与AD相比，MCI患者的认知保留情况更好，这表明后者可能从持续而非定期治疗中获益更多。本研究证实了CT和PT在减轻MCI和AD患者认知衰退方面的积极作用，并且首次证明了它们在维持认知功能方面具有相似的有效性。
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