在轻度认知障碍中,功能能力与行为干预的高依从性有关

Priscilla A Amofa Sr, Brittany L. DeFeis, Liselotte De Wit, D. O’Shea, Andrea Mejia, M. Chandler, D. Locke, J. Fields, V. Phatak, Pamela Dean, J. Crook, Glenn E. Smith
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引用次数: 17

摘要

目的:早期记忆衰退的行为干预有望延缓痴呆的发展。在本研究中,对多模式行为干预研究的参与者进行了干预后依从性和依从性预测因素的评估。方法:诊断为遗忘性轻度认知障碍(aMCI)的参与者(N = 272,平均年龄= 75.04±7.54)被分配到干预组,接受五种行为干预成分中的四种,包括瑜伽、记忆补偿训练、计算机认知训练、支持小组和/或健康教育。干预时间为10天,每天4小时,干预后随访6、12、18个月。结果:237名参与者完成了干预后6个月的随访,228名参与者完成了12个月的随访,218名参与者完成了18个月的随访。参与者平均完全遵守了4个教学干预成分中的2个。在干预后6个月、12个月和18个月的随访中,89%的参与者至少部分地遵守了一个或多个教授的干预成分。在所有三个随访时间点上,身体活动对干预的坚持程度最高,而团体支持对干预的坚持程度最低。较高的教育水平、较高的基线抑郁症状、较高的基线整体认知功能以及较好的基线和并发功能能力与干预后的依从性相关。结论:功能能力的改变与aMCI患者的疾病进展有关。在本研究中,受过高等教育、抑郁症状更严重、基线功能能力更好的aMCI患者更有可能长期坚持行为干预成分。干预后的依从性也与并发的日常功能有关。
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Functional ability is associated with higher adherence to behavioral interventions in mild cognitive impairment
Abstract Objective: Behavioral interventions during early memory decline hold promise in delaying the development of dementia. In the present study, participants in a multimodal behavioral intervention study were assessed for post-intervention adherence and predictors of adherence. Methods: Participants (N = 272, mean age = 75.04 ± 7.54) diagnosed with amnestic Mild Cognitive Impairment (aMCI) were assigned to intervention groups receiving four out of five behavioral intervention components, including yoga, memory compensation training, computerized cognitive training, support groups, and/or wellness education. Length of the intervention was 10 days, 4 h per day, with post-intervention follow-up at 6, 12, and 18 months. Results: Two-hundred and thirty-seven participants completed the 6-month post-intervention follow-up measures, 228 participants completed the 12-month measures, and 218 participants completed the 18-month measures. Participants fully adhered to a mean of 2 out of the 4 taught intervention components. Eighty-nine percent of participants were at least partially adherent to one or more taught intervention components at 6-, 12-, and 18-month post-intervention follow-up. Physical activity was the most adhered to intervention while group support was the least adhered to intervention across all three follow-up time-points. Higher educational level, higher baseline depressive symptoms, higher baseline global cognitive functioning, and better baseline and concurrent functional abilities were associated post-intervention adherence. Conclusion: Changes in functional abilities are associated with disease progression among persons with aMCI. In the present study, individuals with aMCI who have higher education, higher depressive symptoms, and better baseline functioning abilities are more likely to adhere to behavioral intervention components over time. Post-intervention adherence also associates with concurrent daily function.
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