Zanetti O, Frisoni G B, De Leo D, Dello Buono M, Bianchetti A, Trabucchi M
Alzheimer Disease Research and Care Unit, S. Cuore Fatebenefratelli Hospital, Brescia, Italy.
Alzheimer Dis Assoc Disord. 1995 Fall;9(3):132-8.
The aim of this controlled study was to evaluate the effects of a long-term program of formal didactic group therapy [class reality orientation therapy (ROT)] in Alzheimer disease. The study was conducted in the day hospital of an Alzheimer Dementia Research and Care Unit (Brescia, Italy), a multidisciplinary care center providing diagnostic evaluation and treatment for elderly patients with cognitive impairment. The criteria for the inclusion of patients in the study were mild to moderate cognitive impairment [Mini Mental Status Examination (MMSE) between 11 and 24/30] and absence of major aphasia, blindness, and overt behavioral disturbances such as wandering or agitation. Sixteen patients constituted the experimental group and 12 the control group. The last cognitive, functional, and affective evaluation in the experimental and control group was performed 8.2 and 8.5 months after baseline assessment, respectively. The experimental group had repeated cycles of 1-month ROT classes, and 5-7 weeks was allowed between each cycle. Differential change for MMSE score between the two groups was significant. In the experimental group, there was mild improvement in MMSE score (0.68 point) at the last assessment, whereas the control group declined (-2.58 points). This treatment effect on MMSE score (3.27 points) was controlled for potential confounders in a multiple regression analysis. Adjusted treatment effect, including age, education, baseline MMSE, disease duration, disease severity, number of diseases other than Alzheimer, and time elapsing from baseline to last assessment, was very slightly lower: 3.12. In the experimental group, treatment effect was evaluated by comparing ROT cycle changes and resting period changes. A clearly significant treatment effect was found for MMSE and verbal fluency.
这项对照研究的目的是评估长期正规讲授式团体治疗项目[课堂现实定向疗法（ROT）]对阿尔茨海默病的影响。该研究在一家阿尔茨海默病痴呆研究与护理单元（意大利布雷西亚）的日间医院进行，这是一个为认知障碍老年患者提供诊断评估和治疗的多学科护理中心。纳入该研究的患者标准为轻度至中度认知障碍[简易精神状态检查表（MMSE）评分为11至24/30]，且无严重失语、失明以及诸如徘徊或激动等明显行为障碍。16名患者构成实验组，12名患者构成对照组。实验组和对照组分别在基线评估后8.2个月和8.5个月进行了最后的认知、功能和情感评估。实验组接受重复的为期1个月的ROT课程循环，每个循环之间间隔5至7周。两组之间MMSE评分的差异变化具有显著性。在实验组中，最后一次评估时MMSE评分有轻度改善（0.68分），而对照组则下降了（-2.58分）。在多元回归分析中，对MMSE评分的这种治疗效果（3.27分）进行了潜在混杂因素的控制。调整后的治疗效果，包括年龄、教育程度、基线MMSE、病程、疾病严重程度、除阿尔茨海默病外的疾病数量以及从基线到最后评估所经过的时间，略低一些：3.12。在实验组中，通过比较ROT循环变化和休息期变化来评估治疗效果。发现MMSE和语言流畅性有明显显著的治疗效果。
