Nguyen Sarah A, LAvretsky Helen
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA 90095 USA.
Curr Treat Options Psychiatry. 2020;7(4):447-470. doi: 10.1007/s40501-020-00229-5. Epub 2020 Sep 1.
The use of complementary and integrative medicine (CIM) is on the rise among diverse populations of older adults in the USA. CIM is commonly perceived as safer, less expensive, and more culturally acceptable. There is a growing body of evidence to support the use of CIM, especially mind-body therapies, diet and nutritional supplements used for mental disorders of aging.
We summarize the results of the recent clinical trials and meta-analyses that provide the evidence for the role of CIM in treating older adults with mood or cognitive disorders that includes the use of diet and supplements, and mind-body therapies.
Dietary and mind-body therapies have become increasingly popular and show the strongest evidence of efficacy for mood and cognitive disorders. Although the use of vitamins and supplements is the most popular CIM practice, only mixed evidence supports their use with additional concerns for herb (supplement)-drug interactions. Despite increasing use of CIM by the general population, information to guide clinicians providing care for older adults remains limited with variable scientific rigor of the available RCTs for a large number of commonly used CIM interventions for the mental health of older adults.
在美国,补充与整合医学(CIM)在不同老年人群中的使用呈上升趋势。CIM通常被认为更安全、成本更低且在文化上更容易被接受。越来越多的证据支持使用CIM,尤其是身心疗法、用于老年精神障碍的饮食和营养补充剂。
我们总结了近期临床试验和荟萃分析的结果,这些结果为CIM在治疗患有情绪或认知障碍的老年人中的作用提供了证据,其中包括饮食和补充剂以及身心疗法的使用。
饮食和身心疗法越来越受欢迎,并且在治疗情绪和认知障碍方面显示出最有力的疗效证据。尽管使用维生素和补充剂是最常见的CIM做法,但仅有混合证据支持其使用,且对草药(补充剂)与药物相互作用存在更多担忧。尽管普通人群对CIM的使用日益增加,但指导临床医生为老年人提供护理的信息仍然有限,针对大量常用于老年人心理健康的CIM干预措施的现有随机对照试验的科学严谨性参差不齐。