背景:轻度认知障碍(MCI)患者显然需要有效和可持续的干预措施。尽管多模式干预方法的临床重要性,只有一项使用多模式方法的研究证明了记忆的有希望的改善,注意,和执行功能,这也与50例MCI患者脑激活的功能磁共振成像(MRI)血氧水平依赖性(BOLD)变化相关。
目的:研究BRAIN-FIT多模式干预计划(机器人辅助步态训练(RAGT),计算机化认知疗法,音乐,光,经颅直流电刺激(tDCS),和膈肌呼吸练习)和记忆之间的相关性,浓度,抑郁症,在患有MCI的老年人中睡觉。
方法:从一个主要的大学医学中心和社区痴呆救济中心招募了100名MCI患者(平均值±标准差:8.63±78.4岁;47名女性)。调查问卷包括四个领域,21个问题,包括四个与一般人口特征有关的,八个与锻炼和活动有关,三个与睡眠有关,和9个与大脑修复计划有关。采用卡方检验对李克特量表数据进行分析。计算描述性频率。此外,Spearman的rho统计量测量等级顺序关联。P<0.05有统计学意义。
结果:在记忆和浓度之间观察到很强的相关性(r=0.850,P=0.000),记忆和抑郁(r=0.540,P=0.000),记忆和睡眠(r=0.502,P=0.000),浓度和抑郁(r=0.602,P=0.000),注意力和睡眠(r=0.529,P=0.000)和睡眠和抑郁(r=0.497,P=0.000)。医疗服务与睡眠之间的相关性为中等(r=0.249,P=0.012)。卡方检验显示,记忆力和低强度运动持续时间存在显着差异(χ2[3,N=100]=11.69,P=0.01),浓度和高强度运动持续时间(χ2[3,N=100]=10.08,P=0.02),浓度与低强度运动持续时间(χ2[3,N=100]=21.11,P=0.00),高强度抑郁(χ2[3,N=100]=10.36,P=0.02),高强度运动时间(χ2[3,N=100]=10.48,P=0.02);低强度运动时间(χ2[3,N=100]=7.90,P=0.48),低强度运动持续时间(χ2[3,N=100]=9.69,P=0.02)。此外,睡眠和高强度之间存在显着差异(χ2[3,N=100]=10.36,P=0.02),低强度(χ2[3,N=100]=18.14,P=0.00),低强度运动持续时间(χ2[3,N=100]=18.30,P=0.00)。在参与者中,5%的人回答了RAGT,20%的人回答他们经历过电脑认知疗法。音乐疗法(20%)膈肌呼吸练习(45%),和光治疗(10%)。没有患者经历过tDCS。相反,11%的参与者回答了RAGT他们想要体验的项目,21%的参与者回答了计算机化的认知疗法。25%的音乐疗法,22%的膈肌呼吸练习,5%的光疗,16%的tDCS参与者表示他们想体验它。最后,63%的参与者希望参加BRAIN-FIT计划。
结论:本研究的结果提供了基于临床证据的见解,即在MCI中利用BRAIN-FIT来最大程度地改善记忆的认知评分,浓度,抑郁症,和睡眠。因此,在设计大脑FIT时,根据调查,按偏好比例设置了六个干预项目,以减少参与者的排斥感。该程序是根据运动强度配置的。
BACKGROUND: Effective and sustainable interventions are clearly needed for mild cognitive impairment (MCI) patients. Despite the clinical importance of the multimodal intervention approach, only one study using a multimodal approach demonstrated promising improvements in memory, attention, and executive functions, which also correlated with functional magnetic resonance imaging (MRI) blood oxygenation level dependent (BOLD) changes in cerebral activation in 50 MCI patients.
OBJECTIVE: To investigate the self-perception and anticipated efficacy of each element of the BRAIN-FIT multimodal intervention program (robotic-assisted gait training (RAGT), computerized cognitive therapy, music, light, transcranial direct current stimulation (tDCS), and diaphragmatic breathing exercises) and the correlation between memory, concentration, depression, and sleep in older adults with MCI.
METHODS: One hundred participants (mean±standard deviation: 8.63±78.4 years; 47 women) with MCI were recruited from a major university medical center and community dementia relief center. The survey questionnaire comprised four domains with 21 questions, including four pertaining to general demographic characteristics, eight related to exercise and activity, three related to sleep, and nine related to the BRAIN-FIT program. Chi-squared test was used to analyze the Likert scale data. The descriptive frequencies were calculated. Additionally, Spearman\'s rho statistics measure the rank-order association. The statistical significance was at P < 0.05.
RESULTS: A strong correlation was observed between memory and concentration (r = 0.850, P = 0.000), memory and depression (r = 0.540, P = 0.000), memory and sleep (r = 0.502, P = 0.000), concentration and depression (r = 0.602, P = 0.000), concentration and sleep (r = 0.529, P = 0.000) and sleep and depression (r = 0.497, P = 0.000). The correlation between medical services and sleep (r = 0.249, P = 0.012) was moderate. The chi-square test revealed a significant difference in memory and low-intensity duration of exercise (χ2[3,N = 100] = 11.69, P = 0.01), concentration and high-intensity exercise duration (χ2[3,N = 100] = 10.08, P = 0.02), concentration with low-intensity exercise duration (χ2[3,N = 100] = 21.11, P = 0.00), depression with high-intensity (χ2[3,N = 100] = 10.36, P = 0.02), high-intensity duration of exercise (χ2[3,N = 100] = 10.48, P = 0.02); low-intensity (χ2[3,N = 100] = 7.90, P = 0.48), and low-intensity duration of exercise (χ2[3,N = 100] = 9.69, P = 0.02). Additionally, significant differences were observed between sleep and high-intensity (χ2[3, N = 100] = 10.36, P = 0.02), low-intensity (χ2[3, N = 100] = 18.14, P = 0.00), and low-intensity duration of exercise (χ2[3, N = 100] = 18.30, P = 0.00). Among the participants 5% answered RAGT, and 20% responded that they had experienced computerized cognitive therapy. Music therapy (20 %), diaphragmatic breathing exercises (45 %), and light therapy (10 %) were used. No patient had experienced tDCS. Conversely, 11% of the participants answered RAGT for programs they wanted to experience and 21% responded to computerized cognitive therapy. 25% of music therapy, 22% of diaphragmatic breathing exercises, 5% of light therapy, and 16% of tDCS participants said they wanted to experience it. Finally, 63% of the participants wanted to participate in the BRAIN-FIT program.
CONCLUSIONS: The present study\'s results provide clinical evidence-based insights into the utilization of BRAIN-FIT in MCI to maximize cognitive score improvement of memory, concentration, depression, and sleep. Therefore, when designing the BRAIN-FIT, six intervention items were set in proportion to the preference based on the survey, to reduce participants\' feeling of repulsion. The program was configured according to exercise intensity.