认知衰弱伴抑郁症状老年人多维康复管理的证据总结

Evidence summary of multidimensional rehabilitation management of cognitive frailty in the elderly with depression

目的:汇总归纳认知衰弱伴抑郁症状老年人多维康复管理的最佳证据,为后续基于循证理念精准化干预方案构建、认知衰弱行业标准规范完善提供理论依据。方法:根据“6S”模型,系统检索国内外数据库及各学会网站,检索时限为建库至2023年9月。由2名循证研究者对纳入文献分别独立进行质量评价,确定证据等级与推荐级别。结果:共纳入文献21篇,其中指南3篇、专家共识2篇、临床决策1篇、系统评价4篇、类实验研究2篇、证据总结2篇、随机对照试验7篇。最终汇总了21条证据,包括多维康复管理的有效性/必要性、运动康复、认知康复、营养康复、物理治疗、用药康复、心理治疗、教育康复8个主题。结论:临床实践可基于本研究提取的最佳证据,结合伴抑郁症状的认知衰弱病人及照护者需求,精准制定科学、全面、有效的康复管理方案,促进循证证据转化落实,延缓或避免不良健康结局发生。

Objective:To provide a comprehensive review of the best available evidence on multidimensional rehabilitation management for cognitive frailty and depression in older adults,serving as a theoretical foundation for the development of precise interventions based on evidence-based concepts and the enhancement of industry standards and specifications related to cognitive frailty.Methods:Following the"6S"model,we systematically searched domestic and foreign databases and websites of various societies,and retrieval time was from the inception to September 2023.Two researchers independently assessed literature quality,determined levels of evidence and recommendations.Results:A total of 21 papers were included,involving 3 guidelines,2 expert consensus,1 clinical decision-making,4 systematic evaluations,2 class experimental studies,2 evidence summaries,and 7 randomized controlled trials.A total of 21 pieces of evidence were summarised from 8 themes,covering the effectiveness/necessity of multidimensional rehabilitation management,exercise rehabilitation,cognitive rehabilitation,nutritional rehabilitation,physiotherapy,medication rehabilitation,psychotherapy,and educational rehabilitation.Conclusion:By integrating the findings from this study with patient and caregiver needs,clinical practice can develop scientifically sound,comprehensive,and effective rehabilitation management programs that facilitate the translation and implementation of evidence-based practices.This approach may help delay or prevent adverse health outcomes.