步行对阿尔茨海默病患者认知功能和生活质量的影响

Effects of walking on cognitive function and quality of life in patients with Alzheimer's disease

目的探讨步行对阿尔茨海默病(AD)患者的日常生活能力(ADL)、认知功能以及跌倒风险的影响。方法将92例AD患者随机分为干预组(常规药物治疗+步行)和对照组(常规药物治疗),治疗6个月。治疗前后应用Barthel指数(BI)、AD评定量表认知量表(ADAS-Cog)、跌倒风险评估工具(FRAT)及Berg平衡量表(BBS)进行评定。结果治疗前,两组患者的性别、年龄、教育年限以及各量表的评分比较,差异无统计学意义。治疗后,干预组患者FRAT评分明显降低、BBS评分明显升高、BI指数及ADAS-Cog评分无明显变化;对照组患者BI指数明显降低、ADAS-Cog评分明显升高、FRAT评分及BBS评分无明显变化。结论步行能延缓AD患者ADL及认知功能的下降,并且降低AD患者跌倒的风险,从而提高AD患者的生活质量。

【Objective】 To clarify effects of walking on activity of daily living（ADL）, cognitive function,and risk of falls in the patients with Alzheimer＇s disease（AD）. 【Methods】 Ninety-two patients with AD were randomly allocated to one of two groups： the intervention group（IG）, which had the physical exercise therapy（walking） in addition to conventional treatment and the control group（CG） which received conventional treatment only. Some scales were assessed at pre and post intervention moment（T0and T1）. ADL was assessed by the Barthel Index（BI）. The severity of cognitive impairment was assessed by the Alzheimer＇s Disease Assessment Scale-cognitive subscale（ADAS-Cog）. The risk of falls was assessed by the Falls Risk Assessment Tool（FRAT） and the Berg Balance Scale（BBS）. 【Results】 There were no significant differences between the two groups in gender, age, education level, scores of BI, ADAS-Cog, FRAT or BBS at T0. There was a significant decrease in the FRAT score, a significant increase in the BBS score and no significant difference in the BI or ADAS-Cog score of the IG at T1 compared to T0. There was a significant decrease in the BI score, a significant increase in the ADAS-Cog score and no significant difference in FRAT or BBS score of the CG at T1 compared to T0. 【Conclusions】 Walking can postpone the decline of ADL and cognitive function and reduce the risk of falls in patients with AD.