老年轻度认知功能障碍早期干预的循证与实证研究

发布时间：2018-02-23 03:22

本文关键词： 轻度认知功能障碍循证分析实证研究干预　出处：《苏州大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的 1、循证分析各种干预措施对改善老年人轻度认知功能障碍的效果，为实证研究提供一定的参考依据。 2、实证研究综合性干预措施对轻度认知功能障碍患者的作用，为改善老年人认知功能、延缓向老年痴呆的转化提供依据。方法 1、文献检索：通过计算机检索中国知网全文期刊、重庆维普VIP全文数据库、万方电子期刊数据库、MEDLINE、SpringerLink电子期刊以及Ovid全文电子数据库，收集国内外2000年1月～2012年11月间公开发表的关于轻度认知功能障碍干预措施的文献。中文检索词为“轻度认知功能损害”、“轻度认知功能障碍”，联合关键词为“干预”、“营养干预”、“药物干预”、“体育锻炼”、“认知训练”。检索外文数据库的主题词为“Mild Cognitive Impairment”、“Age-Related Cognitive Decline”、“Age-Associated Memory Impairment”、“Intervention”、“Nutrition Intervention”、“MedicineIntervention”、“Physical Activity”、“Cognitive Training”。 2、实证调查：对社区老年人进行轻度认知障碍筛查，将筛选出的轻度认知障碍患者随机分为干预组与对照组，对干预组进行体育锻炼和认知训练等方面的干预，对照组仍进行正常的社区活动。最后采用蒙特利尔量表（MoCA）测量两组患者在基线、3个月及6个月的认知功能得分情况，评价干预的效果。采用EpiData3.0软件建立数据库录入数据并校对。采用SPSS17.0对资料进行统计描述。运用独立样本的t检验比较干预组与对照组的MoCA各项得分情况、用配对的t检验分析干预组与对照组的前后得分情况。结果 1、循证分析：通过对轻度认知障碍的各项干预措施进行meta分析后发现，体育锻炼和认知训练以及营养干预里的维生素和地中海饮食的干预结果是有统计学意义的。其合并效应量分别为：体育锻炼（OR=0.57,95%CI:0.52-0.62）、认知训练（OR=3.09,95%CI:2.01-4.17）、维生素（OR=0.79,95%CI:0.61-0.98）、地中海饮食（OR=0.61,95%CI:0.49-0.73）。 2、实证研究：对干预组和对照组的基线资料进行比较，结果具有均衡性。干预3个月时，除注意力和总分外，两组间其他各项MoCA得分的差别都没有统计学意义（P0.05）。6个月时除视觉网与执行功能和抽象记忆外，，其他各项得分及总分的差别都具有统计学意义（P0.05）。结论 1、循证研究发现体育锻炼和认知训练以及营养干预里的维生素和地中海饮食能够在一定程度上改善老年人的认知功能，这为实证研究提供了一定依据。 2、实证研究发现，经过3-6个月体育锻炼和认知训练相结合的综合性干预，对轻度认知障碍患者的认知功能改善是有效果的。
[Abstract]:Purpose 1 . Evidence - based analysis of the effects of various intervention measures on the improvement of mild cognitive impairment in the elderly provides some reference for the empirical research . 2 . The effect of comprehensive intervention measures on patients with mild cognitive impairment was studied in order to improve the cognitive function of the elderly and delay the transformation of senile dementia . method 1 . Literature search : A literature search of mild cognitive impairment interventions published between January 2000 and November 2012 was collected from January 2000 to November 2012 . The Chinese search term was " Mild Cognitive Impairment " , " Mild Cognitive Impairment " , " Intervention " , " Nutrition Intervention " , " Drug Intervention " , " Physical Exercise " , " Cognitive Training " . The subject words " Age - Related Cognitive Impairment " , " Age - Associated Memory " , " Physical Activity " , " Nutrition Training " were retrieved . 2 . Positive investigation : The patients with mild cognitive impairment were randomly divided into the intervention group and the control group , and the intervention group was divided into the intervention group and the control group , and the control group still carries out normal community activities . Results 1 . Evidence - based analysis : After meta - analysis of the intervention measures of mild cognitive impairment , it was found that physical exercise and cognitive training and the intervention of vitamin and Mediterranean diet were statistically significant in physical exercise ( OR = 0.57 , 95 % CI : 0.52 - 0.62 ) , cognitive training ( OR = 3.09 , 95 % CI : 2.01 - 4.17 ) , vitamin ( OR = 0.79 , 95 % CI : 0.61 - 0.98 ) , Mediterranean diet ( OR = 0.61 , 95 % CI : 0.49 - 0.73 ) . 2 . Positive research : Compared with the baseline data from the intervention group and the control group , the results showed that there was no significant difference between the two groups except attention and total score ( P0.05 ) . Conclusion 1 . Evidence - based research has found that physical exercise and cognitive training and vitamin and Mediterranean diet in nutrition intervention can improve the cognitive function of the elderly to a certain extent , which provides a basis for the empirical research . 2 . The empirical study found that the comprehensive intervention combined with 3 - 6 months of physical exercise and cognitive training was effective in improving cognitive function in patients with mild cognitive impairment .

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.16

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