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认知康复对老年人认知、淡漠、生活质量和主观抱怨的影响:一项随机对照试验。

Effects of Cognitive Rehabilitation on Cognition, Apathy, Quality of Life, and Subjective Complaints in the Elderly: A Randomized Controlled Trial.

机构信息

Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain.

Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain.

出版信息

Am J Geriatr Psychiatry. 2020 May;28(5):518-529. doi: 10.1016/j.jagp.2019.10.011. Epub 2019 Oct 21.

Abstract

OBJECTIVE

To determine the efficacy of a new-generation integrative cognitive rehabilitation (CR) program (Rehacop) on cognition, clinical symptoms, quality of life (QoL), and subjective complaints in the elderly.

DESIGN

A randomized controlled trial study with a cohort of elderly people over 55 years of age.

SETTING

Communities of the Basque Country (Spain).

PARTICIPANTS

A total of 124 elderly participants (aged 79.00 ± 8.85 years) were randomized in the Rehacop group (RG) (n = 62) and control group (CG) (n = 62).

INTERVENTION

The RG attended 39 CR sessions for 3 months (3 sessions/week, 60-minute/session) with the Rehacop program. The CG performed occupational tasks with the same frequency and duration as the RG.

METHODS

Participants underwent a neuropsychological assessment at baseline and post-treatment which included cognitive, clinical, and functional tests. In addition, participants and their formal caregivers completed a subjective complaints questionnaire. The data were analyzed according to the intention to treat analysis and with participants who completed the study. This study was registered at clinicaltrials.gov (NCT03435029).

RESULTS

The RG showed significant improvements compared to the CG in neurocognition (ANCOVA timexgroup interaction effect size (η)=0.05, 90% confidence interval (CI) = 0.00-0.12). The RG also reduced apathy (η=0.06, 90% CI = 0.01-0.15) and participants' subjective complaints (η=0.11, 90% CI = 0.03-0.21) and improved QoL (η=0.08, 90% CI = 0.01-0.17).

CONCLUSIONS

Participants who attended the intervention improved their cognition, QoL, and reduced apathy and subjective complaints after treatment. These findings provide a new understanding of the benefits of CR in the elderly.

摘要

目的

确定新一代综合认知康复(CR)计划(Rehacop)对老年人认知、临床症状、生活质量(QoL)和主观抱怨的疗效。

设计

一项随机对照试验研究,有一个 55 岁以上的老年人队列。

地点

西班牙巴斯克地区的社区。

参与者

共有 124 名老年人(年龄 79.00±8.85 岁)被随机分为 Rehacop 组(RG)(n=62)和对照组(CG)(n=62)。

干预措施

RG 参加了 39 次 CR 课程,为期 3 个月(每周 3 次,每次 60 分钟),采用 Rehacop 方案。CG 以与 RG 相同的频率和时长进行作业治疗。

方法

参与者在基线和治疗后进行神经心理学评估,包括认知、临床和功能测试。此外,参与者及其正式护理人员完成了一份主观抱怨问卷。根据意向治疗分析和完成研究的参与者对数据进行了分析。本研究在 clinicaltrials.gov 上注册(NCT03435029)。

结果

与 CG 相比,RG 在神经认知方面有显著改善(ANCOVA timexgroup 交互效应大小(η)=0.05,90%置信区间(CI)=0.00-0.12)。RG 还减少了冷漠(η=0.06,90% CI=0.01-0.15)和参与者的主观抱怨(η=0.11,90% CI=0.03-0.21),并提高了生活质量(η=0.08,90% CI=0.01-0.17)。

结论

参加干预的参与者在治疗后改善了认知、生活质量,并减少了冷漠和主观抱怨。这些发现为 CR 在老年人中的益处提供了新的认识。

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