Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia - Randomised controlled trial
Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia - Randomised controlled trial
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DOI：
10.1192/bjp.183.3.248
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发表时间：
2003-09-01
影响因子：
10.5
通讯作者：
Orrell, M
中科院分区：
文献类型：
--
作者：
Spector, A;Thorgrimsen, L;Orrell, M
背景：最近Cochrane对现实定向疗法的一项综述指出，需要进行大型、精心设计的多中心试验。目的检验认知刺激疗法(CST)对老年痴呆患者的认知和生活质量的改善这一假设。方法采用单盲、多中心、随机对照试验，共招募201名老年痴呆患者。主要观察指标为认知功能和生活质量的变化。意向处理分析使用协方差分析来控制基线测量中的潜在变异性。结果在中心内随机将115人分为干预组，86人分为对照组。在随访时，干预组在简易智力状态检查(P=0.044)、阿尔茨海默病认知评定量表(ADAS-COG)(P=0.014)和阿尔茨海默病生活质量量表(P=0.028)上均明显优于对照组。以ADAS-Cog评分提高4分或以上为标准，干预组需要治疗的个数为6个。结论该结果优于痴呆药物试验。CST组织可能对许多痴呆症患者有价值的好处。利益声明没有。在致谢中详细说明了资金。
Background A recent Cochrane review of reality orientation therapy identified the need for large, well-designed, multi-centre trials.Aims To test the hypothesis that cognitive stimulation therapy (CST) for older people with dementia would benefit cognition and quality of life.Method A single-blind, multi-centre, randomised controlled trial recruited 201 older people with dementia. The main outcome measures were change in cognitive function and quality of life. An intention-to-treat analysis used analysis of covariance to control for potential variability in baseline measures.Results One hundred and fifteen people were randomised within centres to the intervention group and 86 to the control group. At follow-up the intervention group had significantly improved relative to the control group on the Mini-Mental State Examination (P=0.044), the Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) (P=0.014) and Quality of Life Alzheimer's Disease scales (P=0.028). Using criteria of 4 points or more improvement on the ADAS-Cog the number needed to treat was 6 for the intervention group.Conclusion The results compare favourably with trials of drugs for dementia. CST groups may have worthwhile benefits for many people with dementia.Declaration of interest None. Funding detailed in Acknowledgements.