Cognitive stimulation therapy for Alzheimer's disease: the effect of cognitive stimulation therapy on the progression of mild Alzheimer's disease in patients treated with donepezil
Cognitive stimulation therapy for Alzheimer's disease: the effect of cognitive stimulation therapy on the progression of mild Alzheimer's disease in patients treated with donepezil
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DOI：
10.1017/s1041610206004194
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发表时间：
2007-04-01
影响因子：
7
通讯作者：
Matsuda, Osamu
中科院分区：
文献类型：
--
作者：
Matsuda, Osamu
背景：关于乙酰胆碱酯酶抑制剂(如多奈哌齐)在阿尔茨海默病(AD)中的益处已达成普遍共识。然而，乙酰胆碱酯酶和认知刺激疗法(CST)的联合作用仍存在争议。目的：通过比较17例接受CST和多奈哌齐治疗的AD患者(联合治疗组)和13例单用多奈哌齐的AD患者(对照组)的认知功能，探讨它们对AD认知功能下降进展的影响。方法：联合治疗组患者每天服用5 mg多奈哌齐，CST治疗约20次，持续一年，而对照组每天仅服用5 mg多奈哌齐。前八次会议每周举行一次，随后的会议一般每两周举行一次。在CST开始前(基线)和大约一年后(随访)，用简易智力状态检查(MMSE)评估患者认知能力的变化。结果：重复测量方差分析显示组x时间交互作用显著。对照组MMSE评分明显下降，而综合治疗组无明显变化。对照组中的3名患者在MMSE上下降了4分，而联合治疗组没有一名患者。对照组的效应大小(ES)较大且为负值，而联合治疗组的效应大小接近于零。
Background: There is general consensus regarding the benefit of acetylcholinesterase inhibitors (e.g. donepezil) in Alzheimer's disease (AD). However, the combined effect of acetylcholinesterase and cognitive stimulation therapy (CST) is still controversial.Objective: This study examines their combined effect on the progression of cognitive decline in AD by comparing the cognitive performance of 17 AD patients treated with CST and donepezil (combined treatment group) and 13 AD patients treated with donepezil alone (control group).Methods: Patients in the combined treatment group received 5 mg of donepezil per day and about 20 one-hour CST sessions for one year, whereas the control group received only 5 mg of donepezil per day. The first eight sessions were carried out once a week, and subsequent sessions were generally once every two weeks. The patients were evaluated for changes in cognitive ability by administering the Mini-mental State Examination (MMSE) before the start of CST (baseline) and about one year later (follow-up).Results: A repeated-measure analysis of variance revealed a significant group x time interaction. The MMSE score decreased significantly in the control group, but did not change significantly in the combined treatment group. Three patients in the control group declined by four points on the MMSE, compared to none in the combined treatment group. Effect size (ES) in the control group was relatively large and negative, while the ES in the combined treatment group was close to zero.