|
|
|
| Multimodal non-pharmacological interventions for Alzheimer's disease: a review |
| ZHOU Ying1, LI Lian2, BIAN Guolin2
|
1. School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang 315211, China;
2. The Affiliated Kangning Hospital of Ningbo University, Ningbo, Zhejiang 315201, China |
|
|
|
|
Abstract Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive dysfunction and behavioral impairments. Currently, the treatment mainly relies on pharmacotherapy, yet its effectiveness is limited and accompanied by adverse reactions. Multimodal non-pharmacological interventions (MNPI), which combine two or more non-pharmacological intervention approaches, can synergistically improve cognitive function, neuropsychiatric symptoms, activities of daily living, and quality of life in AD patients, and offers advantages of safety, cost-effectiveness and simplicity. This article reviews MNPI-related literature published domestically and internationally from 2018 to 2024, and focuses on the application of cognitive training, physical activity, and other combined intervention methods in MNPI, providing the reference for developing personalized interventions for AD.
|
|
Received: 08 July 2024
Revised: 16 October 2024
Published: 13 December 2024
|
|
|
|
|
|
[1] World Health Organization.Global status report on the public health response to dementia[R].Geneva:WHO,2019.
[2] 王浩,李娜,俞佳男,等.2003—2017年浙江省阿尔茨海默病发病和死亡趋势分析[J].预防医学,2022,34(3):227-231,239.
[3] JIA L F,DU Y F,CHU L,et al.Prevalence,risk factors,and management of dementia and mild cognitive impairment in adults aged 60 years or older in China:a cross-sectional study[J].Lancet Public Health,2020,5(12):661-671.
[4] ABUBAKAR M B,SANUSI K O,UGUSMAN A,et al.Alzheimer's disease:an update and insights into pathophysiology[J].Front Aging Neurosci,2022,14:1-16.
[5] 杨红英,袁月荣.宁波市老年人群阿尔茨海默病筛查结果分析[J].预防医学,2023,35(10):849-855.
[6] CUMMINGS J,ZHOU Y D,LEE G,et al.Alzheimer's disease drug development pipeline:2023[J].Alzheimers Dement,2023,9(2):1-24.
[7] LI X Q,JI M,ZHANG H M,et al.Non-drug therapies for Alzheimer's disease:a review[J].Neurol Ther,2023,12(1):39-72.
[8] CHALFONT G,MILLIGAN C,SIMPSON J.A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia[J].Dementia,2020,19(4):1086-1130.
[9] 王英,董之晓,杨克虎.轻度老年认知障碍的非药物整合式干预:单个案研究[J].中国全科医学,2024,27(3):315-321.
[10] MIOTTO E C,BATISTA A X,SIMON S S,et al.Neurophysiologic and cognitive changes arising from cognitive training interventions in persons with mild cognitive impairment:a systematic review[J/OL].Neural Plast,2018[2024-10-16].https://doi.org/10.1155/2018/7301530.
[11] SUNG C M,JEN H J,LIU D,et al.The effect of cognitive training on domains of attention in older adults with mild cognitive impairment and mild dementia:a meta-analysis of randomised controlled trials[J/OL].J Global Health,2023[2024-10-16].https://doi.org/10.7189/jogh.13.04078.
[12] 林晓璇,蓝萍,车土玲,等.认知训练对阿尔茨海默病的作用机制及其影响研究[J].生物医学,2023,13(2):151-162.
[13] LIN Y,JIANG W J,SHAN P Y,et al.The role of repetitive transcranial magnetic stimulation(rTMS)in the treatment of cognitive impairment in patients with Alzheimer's disease:a systematic review and meta-analysis[J].J Neurol Sci,2019,398:184-191.
[14] LEFAUCHEUR J P,ALEMAN A,BAEKEN C,et al.Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation(rTMS):an update(2014-2018)[J].Clin Neurophysiol,2020,131(2):474-528.
[15] ZHANG F X,QIN Y Y,XIE L F,et al.High-frequency repetitive transcranial magnetic stimulation combined with cognitive training improves cognitive function and cortical metabolic ratios in Alzheimer's disease[J].J Neural Transm,2019,126(8):1081-1094.
[16] QIN T,WANG L Y,XU H Y,et al.rTMS concurrent with cognitive training rewires AD brain by enhancing GM-WM functional connectivity:a preliminary study[J/OL].Cereb Cortex,2024,34[2024-10-16].https://doi.org/10.1093/cercor/bhad460.
[17] 张漫,谭小林,蒋娟,等.经颅磁刺激联合认知训练对AD患者认知及精神行为的影响研究[J].阿尔茨海默病及相关病杂志,2022,5(2):130-133.
[18] TORPIL B,ŞAHIN S,PEKÇETIN S,et al.The effectiveness of a virtual reality-based intervention on cognitive functions in older adults with mild cognitive impairment:a single-blind,randomized controlled trial[J].Games Health J,2021,10(2):109-114.
[19] FOLOPPE D A,RICHARD P,YAMAGUCHI T,et al.The potential of virtual reality-based training to enhance the functional autonomy of Alzheimer's disease patients in cooking activities:a single case study[J].Neuropsychol Rehabil,2018,28(5):709-733.
[20] BUELE J,VARELA-ALDÁS J L,PALACIOS-NAVARRO G.Virtual reality applications based on instrumental activities of daily living(iADLs)for cognitive intervention in older adults:a systematic review[J].J Neuroeng Rehabil,2023,20(1):1-31.
[21] KANG J M,KIM N,LEE S Y,et al.Effect of cognitive training in fully immersive virtual reality on visuospatial function and frontal-occipital functional connectivity in predementia:randomized controlled trial[J/OL].J Med Internet Res,2021,23(5)[2024-10-16].https://doi.org/10.2196/24526.
[22] LIAO Y Y,CHEN I H,LIN Y J,et al.Effects of virtual reality-based physical and cognitive training on executive function and dual-task gait performance in older adults with mild cognitive impairment:a randomized control trial[J].Front Aging Neurosci,2019,11:1-10.
[23] ISO-MARKKU P,AALTONEN S,KUJALA U M,et al.Physical activity and cognitive decline among older adults:a systematic review and meta-analysis[J/OL].JAMA Netw Open,2024[2024-10-16].https://doi.org/10.1001/jamanetworkopen.2023.54285.
[24] TAIT J L,DUCKHAM R L,RANTALAINEN T,et al.Effects of a 6-month dual-task,power-based exercise program on cognitive function,neurological and inflammatory markers in older adults:secondary analysis of a cluster randomised controlled trial[J/OL].Geroscience,2024[2024-10-16].https://doi.org/10.1007/s11357-024-01316-8.
[25] TOMOTO T,LIU J,TSENG B Y,et al.One-year aerobic exercise reduced carotid arterial stiffness and increased cerebral blood flow in amnestic mild cognitive impairment[J].J Alzheimers Dis,2021,80(2):841-853.
[26] COMBOURIEU DONNEZAN L,PERROT A,BELLEVILLE S,et al.Effects of simultaneous aerobic and cognitive training on executive functions,cardiovascular fitness and functional abilities in older adults with mild cognitive impairment[J].Ment Health Phys Act,2018,15:78-87.
[27] SHIMADA H,MAKIZAKO H,DOI T,et al.Effects of combined physical and cognitive exercises on cognition and mobility in patients with mild cognitive impairment:a randomized clinical trial[J].J Am Med Dir Assoc,2018,19(7):584-591.
[28] LANG X S J,ZHAO N,HE Q,et al.Treadmill exercise mitigates neuroinflammation and increases BDNF via activation of SIRT1 signaling in a mouse model of T2DM[J].Brain Res Bull,2020,165:30-39.
[29] ZHAO Z M,YAO M M,WEI L,et al.Obesity caused by a high-fat diet regulates the Sirt1/PGC-1α/FNDC5/BDNF pathway to exacerbate isoflurane-induced postoperative cognitive dysfunction in older mice[J].Nutr Neurosci,2020,23(12):971-982.
[30] BLUMENTHAL J A,SMITH P J,MABE S,et al.Lifestyle and neurocognition in older adults with cognitive impairmenst:a randomized trial[J].Neurology,2019,92(3):212-223.
[31] BLUMENTHAL J A,SMITH P J,MABE S,et al.Longer term effects of diet and exercise on neurocognition:1-year follow-up of the ENLIGHTEN trial[J].J Am Geriatr Soc,2020,68(3):559-568.
[32] SÄRKÄMÖT,SIHVONEN A J.Golden oldies and silver brains:deficits,preservation,learning,and rehabilitation effects of music in ageing-related neurological disorders[J].Cortex,2018,109:104-123.
[33] SHOKRI G,MOHAMMADIAN F,NOROOZIAN M,et al.Effects of remote combine exercise-music training on physical and cognitive performance in patients with Alzheimer's disease:a randomized controlled trial[J].Front Aging Neurosci,2023,15:1-9.
[34] CHEUNG D S K,LAI C K Y,WONG F K Y,et al.The effects of the music-with-movement intervention on the cognitive functions of people with moderate dementia:a randomized controlled trial[J].Aging Ment Health,2018,22(3):306-315. |
|
|
|
