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整体物理认知康复对阿尔茨海默病和轻度认知障碍的干预效果

Intervention Effects of the Holistic Physio-Cognitive Rehabilitation for Alzheimer Disease and Mild Cognitive Impairment.

作者信息

Osawa Aiko, Maeshima Shinichiro, Kamiya Masaki, Ueda Ikue, Itoh Naoki, Kondo Izumi, Arai Hidenori

机构信息

Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.

Education and Innovation Center, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.

出版信息

Ann Geriatr Med Res. 2025 Jun;29(2):207-212. doi: 10.4235/agmr.24.0158. Epub 2025 Feb 25.

Abstract

BACKGROUND

Cognitive decline in dementia often leads to impaired activities of daily living (ADL), which worsens as the condition progresses. Although a complex rehabilitation program that includes exercise, cognitive tasks, and family guidance improves physical ability in people with dementia and mild cognitive impairment (MCI), the effects on cognitive function and ADL remain unclear. We conducted this study to clarify this point.

METHODS

This retrospective observational study was conducted at the outpatient rehabilitation department of the National Center for Geriatrics and Gerontology, Japan. It analyzed 50 MCI and Alzheimer disease (AD) patients who participated in a holistic physico-cognitive rehabilitation (HPCR) program. The control group consisted of 50 patients matched by age, gender, disease, and Barthel Index (BI) from 963 MCI and AD patients who did not undergo HPCR. Cognitive function was assessed using the Mini-Mental State Examination, and ADL was evaluated with the BI.

RESULTS

Both groups showed a significant decline in MMSE scores after 1 year. However, the intervention group maintained its ADL function, while the control group experienced a significant reduction in BI scores.

CONCLUSION

HPCR, combining exercise therapy and cognitive training, may help maintain ADL in patients with MCI and AD despite cognitive decline. This study suggests that rehabilitation plays a crucial role in sustaining daily functioning in dementia care.

摘要

背景

痴呆症患者的认知能力下降往往会导致日常生活活动能力受损,且随着病情进展而恶化。尽管一项包括运动、认知任务和家庭指导的综合康复计划能改善痴呆症和轻度认知障碍(MCI)患者的身体能力,但其对认知功能和日常生活活动能力的影响仍不明确。我们开展本研究以阐明这一点。

方法

本回顾性观察性研究在日本国立老年医学和老年学中心的门诊康复科进行。研究分析了50名参与整体物理认知康复(HPCR)计划的MCI和阿尔茨海默病(AD)患者。对照组由963名未接受HPCR的MCI和AD患者中按年龄、性别、疾病和巴氏指数(BI)匹配的50名患者组成。使用简易精神状态检查表评估认知功能,并用BI评估日常生活活动能力。

结果

两组在1年后简易精神状态检查表(MMSE)评分均显著下降。然而,干预组维持了其日常生活活动能力,而对照组的BI评分显著降低。

结论

结合运动疗法和认知训练的HPCR可能有助于维持MCI和AD患者的日常生活活动能力,尽管其认知能力有所下降。本研究表明,康复在痴呆症护理中维持日常功能方面起着关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b98/12214989/1726f50ee391/agmr-24-0158f1.jpg

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