Chinese General Practice ›› 2024, Vol. 27 ›› Issue (03): 315-321.DOI: 10.12114/j.issn.1007-9572.2023.0395

Special Issue: 阿尔茨海默病最新文章合集

• Original Research • Previous Articles     Next Articles

Non-pharmacological Integrated Interventions in Older Adults with Mild Cognitive Impairment: a Single Case Pilot Study

  

  1. 1School of Philosophy and Sociology, Lanzhou University, Lanzhou 730030, China
    2Evidence-based Social Science Research Center, Lanzhou University, Lanzhou 730030, China
    3Lanzhou Association of Social Workers, Lanzhou 730030, China
    4School of Social Sciences, Harbin Institute of Technology, Harbin 150001, China
  • Received:2023-01-20 Revised:2023-08-10 Published:2024-01-20 Online:2023-10-23
  • Contact: YANG Kehu

轻度老年认知障碍的非药物整合式干预:单个案研究

  

  1. 1730030 甘肃省兰州市,兰州大学哲学社会学院
    2730030 甘肃省兰州市,兰州大学循证社会科学研究中心
    3730030 甘肃省兰州市社会工作协会
    4150001 黑龙江省哈尔滨市,哈尔滨工业大学社会科学学院
  • 通讯作者: 杨克虎
  • 作者简介:
    作者贡献:王英、杨克虎负责研究方案的设计,特别针对研究方法进行了多次会议讨论;王英负责撰写论文的前言和讨论部分;董之晓负责撰写资料与方法及结果部分。所有作者对论文的撰写提供了批判性的修改意见。
  • 基金资助:
    国家社会科学科学基金重大项目(19ZDA142); 兰州大学研究阐释党的二十大精神专项课题(2023lzdxjbkyzx006); 合作共建兰州大学跨文化研究所项目(071200048); 甘肃省基础研究计划-软科学专项资助(23JRZA369)

Abstract:

Background

Cognitive impairment can lead to a decline in cognitive function, depression, and loneliness, as well as decreased self-efficacy and quality of life in older adults.

Objective

To investigate the effects of non-pharmacological integrated interventions on cognitive function, depression, loneliness, self-efficacy, and quality of life in older adults with mild cognitive impairment.

Methods

Based on risk factors for cognitive impairment, a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. Using a single-subject A-B-A experimental design, a 3-month intervention, which was conducted once a week for 60 minutes, was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale-15 (GDS-15), 12-item Short Form Health Survey (SF-12), General Self-Efficacy Scale (GSES), and De Jong Gierveld Loneliness Scale (DJGLS) were administered to the 3 older adults at baseline, 3 months of the intervention, and 3 months after the intervention, to assess the scores of each scale from the 5 dimensions of cognitive function, self-efficacy, quality of life, depression, and loneliness, the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function, quality of life, depression, self-efficacy, and loneliness dimensions.

Results

The 3 older adults included in the study were 74, 70, 73 years old, all married, living with their spouses and grandchildren. The three older adults had MoCA scores of 21, 22, and 24 at baseline, 28, 26, and 27 at 3 months of intervention, and 25, 19, and 23 at 3 months after intervention; GSES scores were 25, 30, and 27 at baseline, 29, 29, and 30 at 3 months of intervention, and 28, 31, and 28 at 3 months after intervention. SF-12 scores were 69, 32, and 51 at baseline, 81, 81, and 83 at 3 months of intervention, and 78, 38, and 59 at 3 months after intervention. The GDS-15 scale scores were 4, 8, and 2 at baseline, 2, 6, and 1 at 3 months of intervention, and 1, 8, and 4 at 3 months after intervention. The DJGLS scores were 8, 7, and 8 at baseline, 5, 5, and 4 at 3 months of intervention, and 5, 5, and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function, quality of life, depression, loneliness, and self-efficacy of the subjects.

Conclusion

For older adults with mild cognitive impairment, it is of great significance to perform a non-pharmacological integrated intervention in terms of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. The MoCA, SF-12, GDS-15, and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention, while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention.

Key words: Non-pharmacological integrated intervention, Aged, Cognitive dysfunction, Quality of life, Depression, Loneliness

摘要:

背景

认知障碍可导致老年人认知功能下降、抑郁、孤独感,以及自我效能感和生活质量的下降。

目的

探讨非药物整合式干预对轻度老年认知障碍患者认知功能、抑郁、孤独感、自我效能感和生活质量的干预效果。

方法

基于认知障碍的风险因素研发了认知功能训练、身体运动、情绪管理、社会连结、健康生活习惯5个维度的非药物整合式干预方案,采用A-B-A单个案受试者设计,于2021年6—12月展开对3名确诊为轻度认知障碍的老年人进行为期3个月,1次/周,60 min/次的干预。于基线、干预3个月后、干预结束后3个月时采用蒙特利尔认知评估量表(MoCA)、自我效能感量表(GSES)、简版生活质量量表(SF-12)、简版老年抑郁量表(GDS-15)、中文版孤独量表(DJGLS)从认知功能、自我效能感、生活质量、抑郁情绪、孤独感5个维度评估3名老年人各量表得分并分析其变化。并在干预结束后3个月进行半结构式访谈,从认知功能、生活质量、抑郁情绪、自我效能感和孤独感维度评估干预效果。

结果

纳入研究的3名老年人年龄为74、70、73岁,均已婚、与配偶和孙辈共同居住。3名老年人的MoCA基线得分为21、22、24分,干预3个月后为28、26、27分,干预结束后3个月为25、19、23分;GSES基线得分为25、30、27分,干预3个月后为29、29、30分,干预结束后3个月为28、31、28分。SF-12基线时得分为69、32、51分,干预3个月后为81、81、83分,干预结束后3个月为78、38、59分。GDS-15基线得分为4、8、2分,干预3个月后为2、6、1分,干预结束后3个月为1、8、4分。DJGLS基线得分为8、7、8分,干预3个月后为5、5、4分,干预结束后3个月为5、5、7分。半结构访谈资料表明,受试者在认知功能、生活质量、抑郁情绪、孤独感、自我效能感5个维度均有改善。

结论

对于患有轻度老年认知障碍的受试老年人而言,从认知功能训练、身体运动、情绪调节、社会连结、健康生活习惯5个维度开展非药物整合式的干预是有意义的,轻度老年认知障碍老年人的MoCA、SF-12、GDS-15、DJGLS得分在干预3个月后均有改善,GSES得分在干预后效果不理想,所有维度得分在干预结束后3个月呈递减趋势。

关键词: 非药物整合式干预, 老年人, 认知功能障碍, 生活质量, 抑郁, 孤独