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一项关于辅助认知刺激疗法对痴呆症认知结果有效性的单盲随机对照试验。

A Single-Blind Randomized Control Trial on the Effectiveness of Adjunct Cognitive Stimulation Therapy on Cognitive Outcomes in Dementia.

作者信息

Bhowmik Soumya, Chandra Mina, Anand Kuljeet, Dahuja Shrishti

机构信息

Department of Neurology, ABVIMS and Dr. RML Hospital, New Delhi, India.

Department of Psychiatry, ABVIMS and Dr. RML Hospital, New Delhi, India.

出版信息

Ann Indian Acad Neurol. 2023 May-Jun;26(3):225-234. doi: 10.4103/aian.aian_928_22. Epub 2023 Apr 17.

Abstract

BACKGROUND

Dementia is characterized by neurocognitive decline which interferes with daily function and independence. Cognitive stimulation therapy (CST) is an evidence-based cognitive psychosocial intervention for people with dementia.

MATERIALS AND METHODS

A prospective interventional study of single-blind RCT design conducted in the Department of Neurology at ABVIMS and Dr RML Hospital amongst patients with DSM-V major neurocognitive disorder aged more than 50 years. Participants were randomized to CST and control groups using a block-randomized design. The control group participants received treatment as usual while the CST group delivered 45-min virtual group CST sessions for a total of 14 sessions over seven weeks. All participants in both groups were assessed at baseline and eight weeks using the Montreal Cognitive Assessment Scale (MoCA), Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog), neuropsychiatric inventory, instrumental activities of daily living, and Zarit Burden Interview for Caregiver Burden (ZBI) by a rater blind to group randomization.

RESULTS

Total MoCA scores improved significantly in the CST group, compared to the control group which showed a statistically significant decrease. The mean total ADAS-Cog score in the CST group improved significantly compared to controls. The Lawton Instrumental Activities of Daily Living Scale showed a statistically significant change in the control group compared to the intervention group. From the comparison of the mean total neuropsychiatric inventory scale, it was observed that there was a statistically significant decrease in the severity of Behavioural and Psychological Symptoms of Dementia (BPSD) symptoms in the CST group. The mean total ZBI score decreased significantly in the CST group favoring less caregiver burden.

CONCLUSION

This study proved that CST has a significant impact on cognitive outcomes in dementia and it also proved its effectiveness in controlling the BPSD outcomes and caregiver burden in dementia.

摘要

背景

痴呆症的特征是神经认知功能下降,这会干扰日常功能和独立性。认知刺激疗法(CST)是一种针对痴呆症患者的循证认知心理社会干预措施。

材料与方法

在ABVIMS和RML医院神经内科对年龄超过50岁的DSM-V重度神经认知障碍患者进行了一项单盲随机对照试验设计的前瞻性干预研究。采用区组随机设计将参与者随机分为CST组和对照组。对照组参与者接受常规治疗,而CST组在七周内共进行14次时长45分钟的虚拟小组CST课程。两组的所有参与者在基线和八周时由对分组随机不知情的评估者使用蒙特利尔认知评估量表(MoCA)、阿尔茨海默病评估量表认知分量表(ADAS-Cog)、神经精神科问卷、日常生活工具性活动以及照顾者负担的Zarit负担访谈量表(ZBI)进行评估。

结果

与显示出统计学显著下降的对照组相比,CST组的MoCA总分显著提高。与对照组相比,CST组的平均ADAS-Cog总分显著改善。与干预组相比,Lawton日常生活工具性活动量表在对照组中显示出统计学显著变化。从平均神经精神科问卷量表的比较中可以观察到,CST组痴呆症的行为和心理症状(BPSD)严重程度有统计学显著下降。CST组的平均ZBI总分显著下降,表明照顾者负担减轻。

结论

本研究证明CST对痴呆症的认知结果有显著影响,并且还证明了其在控制痴呆症的BPSD结果和照顾者负担方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e30c/10394451/01ea2435002a/AIAN-26-225-g001.jpg

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