Lu Yi-Ting, Zhang Xin, Cheng Jun
Department of Psychiatry, Shenyang Mental Health Center, Shenyang 110000, Liaoning Province, China.
Department of Neurology, Shenyang First People's Hospital, Shenyang 110000, Liaoning Province, China.
World J Psychiatry. 2025 Apr 19;15(4):102542. doi: 10.5498/wjp.v15.i4.102542.
There is no effective treatment for Alzheimer's disease (AD), and pharmacological treatment of AD in clinical settings is expensive and prolonged, resulting in a huge psychological and economic burden on the patient's family and caregivers and society as a whole, AD is characterized by progressive, worsening cognitive impairment, and there are currently no drugs that can effectively reverse cognitive impairment. However, it is important to intervene early or delay cognitive impairment so that the condition can be delayed and, ultimately, the burden on patients and families can be reduced through maintenance treatment. It may be that non-pharmacological interventions such as cognitive stimulation therapy (CST) can help with cognitive dysfunction.
To provide a better treatment plan for AD patients and delay the deterioration of cognitive function, the effect of CST on cognitive function in AD was studied by Meta-analysis.
Comprehensive search the Chinese and English databases were comprehensively searched by computer. Chinese databases: China Biomedical Literature Database (CBM), Wanfang Database, VIP Database, and China Periodicals Full-text Database (CNKI). The collection time limit is from July 21, 2010 to July 21, 2022 randomized controlled trials literature on the effects of CST on cognitive function in patients with AD. According to the inclusion and exclusion criteria, literature screening, data extraction, and quality evaluation were performed. Standardized mean difference (SMD) and 95%CI were used as evaluation criteria to evaluate the cognitive function of CST in AD patients. Sensitivity analysis and publication bias detection were performed on the results. Publication bias was assessed using funnel plots, and funnel plot symmetry was assessed with Eggr's test.
CST can not improve Mental State Examination Scale (MMSE) scores in AD patients. Meta-analysis of CST on MMSE scores showed that the heterogeneity was = 0.14, = 35%. = 35% < 50%, and the test > 0.1, choose the random effect model to integrate statistics, get SMD = 0.02, 95%CI: -0.37, 0.42, > 0.05. Meta-analysis of CST on AD Cognitive Functioning Assessment Scale scores showed that the heterogeneity was = 0.13, = 36%. = 36% < 50 choose a fixed effect model to integrate statistics, get SMD = -0.01, 95%CI: -0.40, 0.39, > 0.05, the difference is not statistically significant. Meta-analysis of CST on the cognitive function indicators of patients showed that the heterogeneity was = 0.17, = 31%. = 31% < 50%, the fixed effect model showed SMD = 0.01, 95%CI: -0.37, 0.38, > 0.05, the difference was not statistically significant.
CST may not improve the cognitive function of AD patients, not improve the cognitive function of AD patients, not improve the ability of daily living, and not reduce mental behavior can improve the cognitive function of AD patients.
阿尔茨海默病（AD）尚无有效治疗方法，临床上AD的药物治疗昂贵且疗程长，给患者家庭、照料者及整个社会带来巨大的心理和经济负担。AD以进行性加重的认知障碍为特征，目前尚无能有效逆转认知障碍的药物。然而，尽早干预或延缓认知障碍很重要，以便延缓病情发展，并最终通过维持治疗减轻患者及其家庭的负担。认知刺激疗法（CST）等非药物干预措施可能有助于改善认知功能障碍。
通过Meta分析研究CST对AD患者认知功能的影响，为AD患者提供更好的治疗方案，延缓认知功能恶化。
通过计算机全面检索中英文数据库。中文数据库：中国生物医学文献数据库（CBM）、万方数据库、维普数据库、中国期刊全文数据库（CNKI）。收集时限为2010年7月21日至2022年7月21日关于CST对AD患者认知功能影响的随机对照试验文献。根据纳入与排除标准进行文献筛选、数据提取及质量评价。采用标准化均数差（SMD）及95%可信区间（CI）作为评价指标评估CST对AD患者认知功能的影响。对结果进行敏感性分析及发表偏倚检测。采用漏斗图评估发表偏倚，并用Egger检验评估漏斗图对称性。
CST不能提高AD患者简易精神状态检查表（MMSE）评分。对CST关于MMSE评分的Meta分析显示，异质性I² = 0.14，P = 35%。P = 35% < 50%，且检验P > 0.1，选择随机效应模型进行统计合并，得SMD = 0.02，95%CI：-0.37，0.42，P > 0.05。对CST关于AD认知功能评定量表评分的Meta分析显示，异质性I² = 0.13，P = 36%。P = 36% < 50%，选择固定效应模型进行统计合并，得SMD = -0.01，95%CI：-0.40，0.39，P > 0.05，差异无统计学意义。对CST关于患者认知功能指标的Meta分析显示，异质性I² = 0.17，P = 31%。P = 31% < 50%，固定效应模型显示SMD = 0.01，95%CI：-0.37，0.38，P > 0.05，差异无统计学意义。
CST可能无法改善AD患者的认知功能，不能提高AD患者的日常生活能力，不能减轻精神行为症状，即不能改善AD患者的认知功能。
