医养结合康复模式对阿尔茨海默病患者日常生活活动能力及焦虑抑郁情绪的影响

Effects of rehabilitation mode of combining medical treatment and elderly care on daily living ability,anxiety and depression in patients with Alzheimer’s disease

目的:医养结合康复治疗对阿尔茨海默病(AD)患者日常生活自理能力及焦虑抑郁情绪的影响。方法:选择2016年1月至12月居住在上海徐汇区宛贤敬老院、徐汇区第三老年福利院、徐汇区虹梅养老院的60~80岁轻、中度AD患者100例分为康复组和对照组各50例。对照组给予养老院的常规照料和护理,康复组在对照组的基础上加用由专业康复治疗师进行的康复治疗。分别于干预前、干预6个月和12个月时采用日常生活活动能力量表(ADL)、Hamilton焦虑量表(HAMA)、Hamilton抑郁量表(HAMD)对两组患者进行疗效评定。结果:干预前两组者ADL、HAMA和HAMD评分差异均无统计学意义(P>0.05),干预6个月时康复组HAMA和HAMD评分低于对照组,干预12个月后,康复组患者ADL评分明显高于对照组,HAMA和HAMD评分明显低于对照组,差异均有统计学意义(均P<0.001)。结论:持续的医养结合康复训练模式可以改善轻、中度AD患者的日常生活自理能力和焦虑、抑郁情绪,减慢病情进展,提高生活质量。

Objective:To investigate effects of medical treatment combined with elderly care on daily living selfcare ability,anxiety and depression in patients with Alzheimer’s disease(AD),Methods:One hundred patients with mild and moderate AD aged 60~80 were divided into a rehabilitation group and a control group with 50 cases in each group in Wanxian Elderly House of Xuhui District,the Third Welfare Home for the Elderly of Xuhui District,and Hongmei Nursing Home of Xuhui District,Shanghai.The patients in the control group were given routine care and nursing care and the patients in the observation group on the basis of the control group,rehabilitation treatment by professional rehabilitation therapists was added.Before the intervention,6 months and 12 months after the intervention,the activity of daily living scale(ADL),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were used to evaluate the efficacy of the two groups of patients.Results:There was no significant difference in ADL,HAMA and HAMD scores between the two groups before intervention(P>0.05),after 6 months of intervention,the HAMA and HAMD scores in the rehabilitation group were lower than those in the control group,after 12 months of intervention,the ADL scores of patients in the rehabilitation group were significantly higher than those in the control group,and the HAMA and HAMD scores of patients in the rehabilitation group were significantly lower than those in the control group,and the differences were statistically significant(both P<0.001).Conclusion:The rehabilitation training mode of continuous medical treatment combined with elderly care can improve the self-care ability,anxiety and depression of patients with mild to moderate AD,slow down the progression of the disease,and improve the quality of life.