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多中心随机对照试验,研究个体怀旧疗法对神经认知障碍老年人的影响。

Multicentre randomised controlled trial about the effect of individual reminiscence therapy in older adults with neurocognitive disorders.

机构信息

Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal.

National Reference Centre for Alzheimer's and Dementia Care, Imserso, Salamanca, Spain.

出版信息

Int J Geriatr Psychiatry. 2021 May;36(5):704-712. doi: 10.1002/gps.5469. Epub 2020 Nov 17.

Abstract

OBJECTIVES

To evaluate the effectiveness of a 13-week individual reminiscence therapy (RT) intervention to improve the overall cognitive function, memory, executive function, mood and quality of life (QoL) of people with neurocognitive disorders.

METHODS

A single-blind, multicentre, randomised parallel two-arm controlled trial recruited 251 people with neurocognitive disorders attending 24 institutions providing care and support services for older adults in Portugal. The primary outcome measure was cognitive function (Mini-Mental State Examination [MMSE]). Secondary outcomes were memory (Memory Alteration Test [MAT]), executive function (Frontal Assessment Battery [FAB]), mood (Geriatric Depression Scale-15 [GDS-15]) and self-reported QoL-Alzheimer's disease AD). Participants in the intervention group (n = 131) received 26 individual RT sessions, twice a week, over the course of 13 weeks. Participants in the control group (n = 120) maintained their treatment as usual.

RESULTS

Intention-to-treat analysis showed that, at endpoint assessment, the intervention group had significantly improved in relation to the control group in MMSE (mean difference 1.84, 95% CI [0.80, 2.89], p = .001, d = .44), MAT (mean difference 2.82, 95% CI [0.72, 4.91], p = .009, d = .34) and QoL-AD (mean difference 1.78, 95% CI [0.17, 3.39], p = .031, d = .28). Non-significant improvements were found on FAB (mean difference 0.74, 95% CI [-0.04, 1.52], p = .062, d = .24) and GDS-15 (mean difference -0.63, 95% CI [-1.45, 0.19], p = .130, d = .19).

CONCLUSIONS

For people with neurocognitive disorders attending social care and support services, the individual RT designed for this trial should be considered an intervention with the potential to improve cognition, memory and QoL.

摘要

目的

评估为期 13 周的个体回忆疗法(RT)干预对改善认知功能、记忆、执行功能、情绪和生活质量(QoL)的有效性,该疗法适用于患有神经认知障碍的人群。

方法

这是一项单盲、多中心、随机平行双臂对照试验,共招募了 251 名在葡萄牙 24 个为老年人提供护理和支持服务的机构中就诊的患有神经认知障碍的人群。主要结局测量指标为认知功能(简易精神状态检查 [MMSE])。次要结局指标为记忆(记忆改变测试 [MAT])、执行功能(额叶评估量表 [FAB])、情绪(老年抑郁量表-15 [GDS-15])和自我报告的 QoL-阿尔茨海默病(AD)。干预组(n = 131)接受 26 次个体 RT 治疗,每周两次,共 13 周。对照组(n = 120)维持其常规治疗。

结果

意向治疗分析显示,在终点评估时,与对照组相比,干预组在 MMSE(平均差异 1.84,95%置信区间 [0.80, 2.89],p =.001,d =.44)、MAT(平均差异 2.82,95%置信区间 [0.72, 4.91],p =.009,d =.34)和 QoL-AD(平均差异 1.78,95%置信区间 [0.17, 3.39],p =.031,d =.28)方面的评分显著提高。在 FAB(平均差异 0.74,95%置信区间 [-0.04, 1.52],p =.062,d =.24)和 GDS-15(平均差异 -0.63,95%置信区间 [-1.45, 0.19],p =.130,d =.19)方面,改善不明显。

结论

对于在社会护理和支持服务机构就诊的患有神经认知障碍的人群,本试验设计的个体 RT 应被视为一种具有改善认知、记忆和 QoL 潜力的干预措施。

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