摘要
老年痴呆症的共同特征是神经精神症状。非药物干预措施是治疗这些症状的首选方法。我们回顾了现有的对阿尔茨海默病(AD)的神经精神障碍的心理干预的文献资料,关注对痴呆症人群和照顾者的影响。回忆治疗的干预措施显示了改善痴呆症患者的认知和情绪以及减少照顾者的负担的证据。实际定向治疗与AD人群认知的提高,功能失调行为的减少和制度化管理的风险降低相关。然而,潜在的利益需要持续的计划。认知刺激疗法结合乙酰胆碱酯酶抑制剂,显示了功能能力的改善和负面情绪症状的减少。基于行为研究法的研究发现参与者在干预措施后破坏性行为及焦虑的言语有显著减少,进入受限制区域的减少,漫游频次的减少。有证据表明,只有多组分干预措施才可以减少照顾者的心理疾病的发病率,减轻他们的负担。老年痴呆症的心理学方法的研究的未来的挑战是需要更大量和高质量的基于证据的研究,即通过优化设计的方案,针对其有效性以评估其收益而有明确结果的研究。
关键词: 行为心理症状,行为研究法,负担,认知刺激疗法,痴呆,抑郁。
Current Alzheimer Research
Title:Psychological Interventions for Neuropsychiatric Disturbances in Mild and Moderate Alzheimer’s Disease: Current Evidences and Future Directions
Volume: 13 Issue: 10
Author(s): Marcia Cristina Nascimento Dourado and Jerson Laks
Affiliation:
关键词: 行为心理症状,行为研究法,负担,认知刺激疗法,痴呆,抑郁。
摘要: The occurrence of the neuropsychiatric disturbances is common feature in dementia. Nonpharmacological interventions are the first approach to manage these symptoms. We reviewed the available literature data on psychological interventions for neuropsychiatric disturbances in Alzheimer’s disease (AD) focusing on the significant impact on people with dementia and their caregivers. Reminiscence interventions showed evidences of an improvement in cognition and mood in people with dementia as well as a decrease in caregiver burden. Reality orientation therapy was related to an increase in cognition, a decrease in dysfunctional behaviors and a reduced risk of institutionalization among people with AD. However, the potential benefits need a continued program. Cognitive stimulation therapy showed improvement on the functional ability and decrease negative emotional symptoms, when combined with acetylcholinesterase inhibitor. Studies based on behavioral approaches found a significant reduction in disruptive behaviors following intervention, agitated speech, a reduction in entry into a restricted area and a reduction in wandering frequency across participants. There is evidence that only multicomponent interventions can decrease caregivers’ psychological morbidity and reduce their burden. The challenge for future research in psychological approaches in dementia is related to the need of larger and high quality evidence-base studies with well define outcomes aiming their effectiveness through a well-design protocol to evaluate their benefits.
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Marcia Cristina Nascimento Dourado and Jerson Laks , Psychological Interventions for Neuropsychiatric Disturbances in Mild and Moderate Alzheimer’s Disease: Current Evidences and Future Directions, Current Alzheimer Research 2016; 13 (10) . https://dx.doi.org/10.2174/1567205013666160728143123
DOI https://dx.doi.org/10.2174/1567205013666160728143123 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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