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针对阿尔茨海默病连续体患者的数字健康家庭干预:Ability-TelerehABILITation 试点随机对照试验的结果。

A digital health home intervention for people within the Alzheimer's disease continuum: results from the Ability-TelerehABILITation pilot randomized controlled trial.

机构信息

IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.

Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milan, Italy.

出版信息

Ann Med. 2023 Dec;55(1):1080-1091. doi: 10.1080/07853890.2023.2185672.

Abstract

PURPOSE

This study tested the efficacy of digital-health home intervention for people within the Alzheimer's disease (AD)-continuum.

METHODS

Thirty people within the AD continuum were randomly assigned to a telerehabilitation (ABILITY; 6 males, M=78.2 ± 3.95) or treatment as usual (TAU; 8 males, M=77.13 ± 6.38), performing cognitive and physical activities at home for six weeks. The ABILITY intervention additionally included a digital platform enabling communication between the hospital and the patient's home. Efficiency, such as adherence, perceived fit of demands and skills, usability, and effectiveness measures, including neuropsychological level, neuropsychiatric symptoms, and autonomy in daily living, were collected before (T0), after the treatment (T1), and at the 1-year-follow-up (T2).

RESULTS

The ABILITY program was efficient, with a higher adherence (81% vs. 62%), a higher perceived fit of demands and skills than TAU (<.05), and a good level of technology usability. In terms of effectiveness, a treatment effect (ABILITY > TAU) emerged on the global cognitive level, especially in language, executive functions, and memory domains. Moreover, a treatment carry-over effect (1-year follow-up) was observed in global cognitive functions (especially language) (ABILITY > TAU), behavioral symptoms, and caregiver distress (TAU > ABILITY).

CONCLUSIONS

Our preliminary findings suggest that ABILITY is a promising eHealth intervention to improve at-home treatment adherence and to preserve cognitive and behavioral abilities.

摘要

目的

本研究旨在测试数字健康家庭干预在阿尔茨海默病(AD)连续体中的疗效。

方法

30 名 AD 连续体患者被随机分配到远程康复组(ABILITY;6 名男性,M=78.2±3.95)或常规治疗组(TAU;8 名男性,M=77.13±6.38),在家中进行 6 周的认知和身体活动。ABILITY 干预还包括一个数字平台,使医院和患者家庭能够进行沟通。在治疗前(T0)、治疗后(T1)和 1 年随访(T2)时,收集了效率(如依从性、感知需求和技能的匹配程度、可用性和有效性测量,包括神经心理学水平、神经精神症状和日常生活自主能力)等指标。

结果

ABILITY 方案是有效的,其依从性(81% vs. 62%)更高,感知需求和技能的匹配程度优于 TAU(<.05),且技术可用性较好。在有效性方面,出现了治疗效果(ABILITY>TAU),尤其是在整体认知水平,以及语言、执行功能和记忆领域。此外,还观察到治疗的延续效果(1 年随访)在整体认知功能(尤其是语言)(ABILITY>TAU)、行为症状和照顾者困扰(TAU>ABILITY)方面。

结论

我们的初步研究结果表明,ABILITY 是一种有前途的电子健康干预措施,可以提高家庭治疗的依从性,并保护认知和行为能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c8d/10030155/c81eeaaf5c22/IANN_A_2185672_F0001_C.jpg

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