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多模式非药物干预对改善痴呆患者认知功能的效果:系统评价。

The Effect of Multimodal Non-pharmacological Interventions on Cognitive Function Improvement for People With Dementia: A Systematic Review.

机构信息

Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.

Interdisciplinary Centre Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

出版信息

Front Public Health. 2022 Jul 12;10:894930. doi: 10.3389/fpubh.2022.894930. eCollection 2022.

Abstract

INTRODUCTION

Dementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity. Since dementia is a complex syndrome, multimodal non-pharmacological interventions (MNPIs) are highly recommended. Currently, there is less available evidence to describe the content, length, and frequency of multimodal interventions for cognitive function improvement for people with dementia (PWD).

METHOD

A comprehensive search was performed in PubMed, EMBASE, CINAHL, Web of Science, and Medline international databases. The quality appraisal of the studies was done by the Cochrane risk of bias assessment tools.

RESULTS

A total of 19 controlled trial studies were included. Most of the included studies reported that MNPIs resulted in improvement, stability, or attenuation of decline in cognitive function of PWD. The reported effectiveness of MNPIs on cognitive function ranged from medium (0.29 Cohen's ) to large (2.02 Cohen's ) effect sizes. The median duration of intervention was 12 weeks for a 1-h session.

CONCLUSION

This systematic review showed that MNPIs might improve people's cognitive functions for PWD. Physical exercise, music, and cognitive interventions were used in the content of multimodal interventions in a majority of the studies. Therefore, high-quality randomized controlled trial (RCT) studies with repeated-measured design on the combined effect of physical exercise, music, and cognitive intervention on cognitive function for PWD are recommended.

SYSTEMATIC REVIEW REGISTRATION

http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020222065.

摘要

简介

痴呆是一种进行性脑退化疾病,其特征是认知和独立生活能力逐渐恶化。由于痴呆是一种复杂的综合征,因此强烈推荐采用多种非药物干预措施(MNPIs)。目前,关于改善痴呆患者(PWD)认知功能的多种干预措施的内容、时长和频率的证据较少。

方法

在 PubMed、EMBASE、CINAHL、Web of Science 和 Medline 国际数据库中进行了全面检索。使用 Cochrane 偏倚风险评估工具对研究进行质量评估。

结果

共纳入 19 项对照试验研究。大多数纳入的研究报告称,MNPIs 可改善、稳定或减缓 PWD 的认知功能下降。报告的 MNPIs 对认知功能的有效性范围从中等(0.29 个 Cohen's )到较大(2.02 个 Cohen's )效应量。干预的中位数持续时间为 12 周,每次 1 小时。

结论

本系统评价表明,MNPIs 可能改善痴呆患者的认知功能。在大多数研究中,多种干预措施的内容包括身体锻炼、音乐和认知干预。因此,建议开展高质量的随机对照试验(RCT)研究,采用重复测量设计,研究身体锻炼、音乐和认知干预对痴呆患者认知功能的联合影响。

系统评价注册

http://www.crd.york.ac.uk/PROSPERO/,标识符:CRD42020222065。

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