职业治疗对轻度阿尔茨海默病患者认知的影响:系统化文献综述

Leandra Ramin-Wright, N. Pacheco-Barrios, Sandra Zhong, Marion Stokvis-Blok, A. Barrios-Ruiz, Aala F Elhadi, Stefany Alfaro-Amez, Deborah Estrella, João P. G. Kasakewitch, Cecilia Plaza, Renata Medeiros, Nayara Rutes, Guilherme Areas
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摘要

轻度阿尔茨海默病(AD)是最常见的痴呆症形式,给患者和护理人员带来了很大的负担。由于目前只有对症治疗,职业治疗(OT)在帮助轻度AD患者方面的潜力越来越被认识到。本综述评估了OT在轻度AD患者保持认知功能中的作用。方法:利用PubMed和HINARI平台探讨OT对轻度AD的影响。纳入了涉及AD患者的观察性或临床试验设计的英文研究。排除个案研究和文献综述。两位作者独立选择了这项研究,第三位作者解决了争议。结果:最初检索到43项研究。删除重复后,筛选了34篇摘要,其中21篇入选全文,5篇符合纳入标准。其中,3例报告了阳性结果,2例报告了不良反应。阳性结果为低偏倚风险的观察性研究和一项高偏倚风险的随机对照试验。其余两项具有负面结果的随机对照试验显示偏倚风险较低。讨论:我们的综述表明,尽管方法的差异导致结果不一致,但OT对轻度AD患者的认知没有益处。某些OT干预,如基于回忆和群体认知治疗,在轻度AD的认知改善方面显示出希望。未来的研究应该包括更大的样本、更长的干预和随访期,以更全面地了解OT对轻度AD患者认知能力的影响。
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Effect of Occupational Therapy on Cognition in Patients with Mild Alzheimer’s Disease: A Systematized Literature Review
Introduction: Mild Alzheimer’s Disease (AD), the most prevalent form of dementia, substantially burdens patients and caregivers. With only symptomatic treatments currently available, the potential of Occupational Therapy (OT) in aiding mild AD patients is increasingly recognized. This review evaluates OT’s role in preserving cognitive function in mild AD. Methods: We used PubMed and HINARI platforms to explore the effect of OT on mild AD. Studies in English, with observational or clinical trial designs involving patients with AD, were included. Case studies and literature reviews were excluded. Two authors independently selected the study, with a third resolving disputes. Results: 43 studies were initially retrieved. Post-duplicate removal, 34 abstracts were screened, 21 were selected for full review, and five met the inclusion criteria. Of these, three reported positive results, and two reported adverse effects. Those with positive results are observational studies with a low risk of bias and one RCT with a high risk of bias. The two remaining RCTs with negative consequences showed a low risk of bias. Discussion: Our review suggests no benefit on cognition in mild AD from OT, although methodological variability led to inconsistent findings. Certain OT interventions, like Recollection-Based and Group Cognitive Therapy, showed promise in cognitive improvement for mild AD. Future research should include larger samples, extended interventions, and follow-up periods for a more comprehensive insight into OT’s effects on cognition in mild AD patients.
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