Pitkänen Anneli, Alanen Hanna-Mari, Kampman Olli, Suontaka-Jamalainen Kirsti, Leinonen Esa
Administration Centre, Tampere University Hospital , Tampere , Finland.
Department of Psychiatry, Tampere University Hospital , Pitkäniemi , Finland.
Nord J Psychiatry. 2019 Oct;73(7):401-408. doi: 10.1080/08039488.2019.1645205. Epub 2019 Jul 30.
Increasing attention is focusing on psychosocial interventions for treating patients with dementia. This observational intervention study investigated the impact of physical exercise and music interventions among patients with dementia on an acute psychogeriatric ward. The data were collected during February 2009-December 2010 ( = 89; treatment as usual) and during April 2011-March 2013 ( = 86; treatment as usual with physical exercise, e.g. balance, flexibility, strength training, and music interventions, e.g. singing, listening to music and playing instruments). The primary outcome measure was the Neuropsychiatric Inventory and the secondary outcome measures were the Alzheimer's Disease Cooperative Study-Activities of Daily Living, the Barthel Index, and the Mini-Mental State Examination. In both groups, neuropsychiatric symptoms (NPS) decreased ( < .001) but daily functioning deteriorated ( < .001). No significant between-group differences for either outcome variable were found. Based on linear mixed models, fewer exercise sessions associated with more severe symptoms ( = .030), and the time variable (admission/discharge) with a decline in the level of NPS ( < .001). Moreover, female gender ( = .026) and more exercise sessions ( = .039) associated with an increased level of functioning ( = .031) and the time variable (admission/discharge) with a drop in the level of functioning during hospitalization ( < .001). Although no differences were found between the study groups, analysis within the intervention group suggest that physical exercise may have some positive effects for both NPS and the level of functioning in some patients with dementia while no positive effects regarding music interventions were found.
越来越多的关注集中在针对痴呆症患者的心理社会干预措施上。这项观察性干预研究调查了痴呆症患者在急性老年精神科病房接受体育锻炼和音乐干预的影响。数据收集于2009年2月至2010年12月(n = 89;常规治疗)以及2011年4月至2013年3月(n = 86;常规治疗加上体育锻炼,如平衡、柔韧性、力量训练,以及音乐干预,如唱歌、听音乐和演奏乐器)。主要结局指标是神经精神科问卷,次要结局指标是阿尔茨海默病协作研究日常生活活动量表、巴氏指数和简易精神状态检查表。两组中,神经精神症状(NPS)均有所下降(P < 0.001),但日常功能有所恶化(P < 0.001)。未发现两组间任何结局变量存在显著差异。基于线性混合模型,锻炼次数越少与症状越严重相关(P = 0.030),而时间变量(入院/出院)与NPS水平下降相关(P < 0.001)。此外,女性(P = 0.026)和更多的锻炼次数(P = 0.039)与功能水平提高相关(P = 0.031),时间变量(入院/出院)与住院期间功能水平下降相关(P < 0.001)。尽管研究组之间未发现差异,但干预组内的分析表明,体育锻炼可能对一些痴呆症患者的NPS和功能水平有一些积极影响,而未发现音乐干预有积极影响。