轻中度老年期认知功能障碍患者认知行为干预的效果观察

Clinical Efficacy of Cognitive Behavioral Therapy in Elderly Patients with Mild-to-moderate Cognitive Dysfunction

目的探讨认知行为干预用于老年期轻中度认知功能障碍患者的临床效果。方法选择2010年7月—2013年6月在神经内科门诊或住院老年期轻中度认知功能障碍患者70例,采用随机数字表法将其分为观察组和对照组各35例。对照组患者采用常规药物治疗及护理,观察组患者在常规治疗、护理基础上加用认知行为干预措施,包括认知能力训练、肢体功能训练、生活自理能力训练。分别于干预前,干预后3个月及6个月收集两组患者临床疗效指标,采用简易智力状态检查量表(Mini-Mental State Examination,MMSE)及日常生活量表(Activity of Daily Living Scale,ADL)评估其临床效果。结果干预后3个月观察组MMSE及ADL评分均较干预前明显改善(P<0.05),而对照组改善差异无统计学意义(P>0.05)。干预后6个月观察组MMSE评分及ADL评分较干预前有显著性差异(P<0.01),对照组ADL评分较干预前差异有统计学意义(P<0.05),观察组时间判断力、地点定向、记忆力及语言能力单项评分较干预前改善明显(P<0.05)。结论认知行为干预能明显提高老年期轻中度认知功能障碍患者的认知能力及日常生活自理能力,可有效控制及延缓病情进展。

Objective To investigate the clinical efficacy of cognitive behavioral therapy in elderly patients with mild-to-moderate cognitive dysfunction. Methods From July 2010 to June 2013, seventy patients from Neurology department were randomly divided into observation group（n=35） and control group（n=35）. Patients in control group received conventional drug therapy and routine nursing but those in observation group were treated with cognitive behavioral therapy in addition to routine therapy and nursing. Mini-Mental State Examination（MMSE） and Activity of Daily Living Scale（ADL） were applied for clinical outcome before the treatment and three months and six months after treatment. Results Three months after treatment, there were significant improvement of MMSE and ADL scores in observation group（P〈0.05）, while no significant improvement in control group（P〉0.05）. In observation group, the scores of time orientation, location orientation, memory and language improved significantly（ P〈 0.05）. Conclusion Cognitive behavioral therapy can significantly improve cognitive abilities and daily living skills of elderly patients with mild-to-moderate cognitive dysfunction as well effectively slow their disease progression.