Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease
Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease
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DOI：
10.1212/01.wnl.0000147478.03911.28
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发表时间：
2004-12-28
期刊：
影响因子：
9.9
通讯作者：
Sevilla, C
中科院分区：
文献类型：
--
作者：
Olazarán, J;Muñiz, R;Sevilla, C
目的：评价认知-运动项目对早期阿尔茨海默病（AD）患者接受胆碱酯酶抑制剂（ChEI）治疗的疗效。方法：将轻度认知障碍（MCI）（12例）、轻度AD（48例）和中度AD（24例）（全球恶化量表第3、4和5期）患者随机分为两组，分别接受社会心理支持加认知运动干预（实验组）或单独接受社会心理支持（对照组）。认知运动干预（CMI）包括为期1年的103次认知练习，加上社交和精神运动活动。主要疗效测量是AD评估量表（ADAS-cog）的认知分量表。次要疗效测量是简易精神状态检查、功能活动问卷和老年抑郁量表。在1、3、6和12个月时由盲法评估者进行评估。结果：CMI组患者认知状态维持在第6个月，而对照组患者认知状态明显下降。接受正规教育年数较少的患者的认知反应更高。此外，实验组患者在第12个月情感状态维持或改善的患者较多（实验组75%，对照组47%，p = 0.017）。结论：chei治疗的早期阿尔茨海默病患者的长期CMI产生了额外的情绪和认知益处。
Objective: To evaluate the efficacy of a cognitive-motor program in patients with early Alzheimer disease ( AD) who are treated with a cholinesterase inhibitor (ChEI). Methods: Patients with mild cognitive impairment (MCI) (12), mild AD ( 48), and moderate AD ( 24) ( Global Deterioration Scale stages 3, 4, and 5) were randomized to receive psychosocial support plus cognitive-motor intervention ( experimental group) or psychosocial support alone ( control group). Cognitive-motor intervention (CMI) consisted of a 1-year structured program of 103 sessions of cognitive exercises, plus social and psychomotor activities. The primary efficacy measure was the cognitive subscale of the AD Assessment Scale (ADAS-cog). Secondary efficacy measures were the Mini-Mental State Examination, the Functional Activities Questionnaire, and the Geriatric Depression Scale. Evaluations were conducted at 1, 3, 6, and 12 months by blinded evaluators. Results: Patients in the CMI group maintained cognitive status at month 6, whereas patients in the control group had significantly declined at that time. Cognitive response was higher in the patients with fewer years of formal education. In addition, more patients in the experimental group maintained or improved their affective status at month 12 (experimental group, 75%; control group, 47%; p = 0.017). Conclusions: A long-term CMI in ChEI-treated early Alzheimer disease patients produced additional mood and cognitive benefits.