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[基层医疗中针对轻度认知障碍老年人的认知刺激项目长期效果分析:一项随机对照试验]

[Long-term effect analysis of a cognitive stimulation program in mild cognitive impairment elderly in Primary Care: A randomized controlled trial].

作者信息

Gómez-Soria Isabel, Andrés Esteban Eva María, Gómez Bruton Alejandro, Peralta-Marrupe Patricia

机构信息

Fundación La Caridad, Zaragoza, España; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España.

Grupo «Manejo del paciente sangrante» - IDIPaz (Hospital Universitario La Paz - Madrid). Universidad Rey Juan Carlos, Madrid, España.

出版信息

Aten Primaria. 2021 Aug-Sep;53(7):102053. doi: 10.1016/j.aprim.2021.102053. Epub 2021 Apr 14.

Abstract

OBJECTIVE

To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment.

DESIGN

Randomized controlled trial (CONSORT group norms).

LOCATION

San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain).

PARTICIPANTS

Twenty-nine people over 65 years old with a 24-27 MEC score that completed 48 months follow up. They were randomized between the intervention group (15) and the control group (14).

INTERVENTIONS

The intervention was applied in 10 sessions of 45min for 10 weeks using the red notebook tool for mental activation that works memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention and executive functions.

MAIN MEASUREMENTS

The main outcome variables were MEC-35, Set-test, Barthel index, Lawton-Brody scale, Goldberg anxiety scale and Yesavage geriatric depression scale short form.

RESULTS

Increases of the main result variable over the baseline level of MEC-35 were analyzed. On average, the intervention group obtained higher scores than control: 3.14 points post intervention, 3.76 points after 6 months and 2.26 points more than control group after 12 months. All the differences were statistically significant. After 48 months the intervention group obtained 2 points more than control group. The intervention did not improve verbal fluency, activity daily living and mood.

CONCLUSIONS

Our cognitive stimulation program seems to improve cognitive performance, measured with the variable MEC-35 at post intervention, 6, 12 and 48 months. There is no evidence of improvement in verbal fluency, activity daily livings and mood. Clinicaltrials.gov Identifier: NCT03831061.

摘要

目的

通过一项认知刺激计划,为社区健康干预对轻度认知障碍老年人的长期疗效提供证据。

设计

随机对照试验(CONSORT组规范)。

地点

圣何塞北中心初级保健中心和拉卡里达基金会(西班牙萨拉戈萨)。

参与者

29名65岁以上、蒙特利尔认知评估量表(MEC)得分为24 - 27分且完成48个月随访的人。他们被随机分为干预组(15人)和对照组(14人)。

干预措施

采用红色笔记本工具进行精神激活,针对工作记忆、定向、语言、实践、认知、计算、感知、逻辑推理、注意力和执行功能,在10周内进行10次每次45分钟的干预。

主要测量指标

主要结局变量为MEC - 35、成套试验、巴氏指数、Lawton - Brody量表、戈德堡焦虑量表和Yesavage老年抑郁量表简表。

结果

分析了主要结果变量相对于MEC - 35基线水平的增加情况。平均而言,干预组得分高于对照组:干预后3.14分,6个月后3.76分,12个月后比对照组多2.26分。所有差异均具有统计学意义。48个月后,干预组比对照组多得2分。干预未改善语言流畅性、日常生活活动能力和情绪。

结论

我们的认知刺激计划似乎能改善认知表现,在干预后、6个月、12个月和48个月时用MEC - 35变量测量。没有证据表明语言流畅性、日常生活活动能力和情绪有所改善。Clinicaltrials.gov标识符:NCT03831061。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66cc/8066353/5d511c11c841/gr1.jpg

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