Efficacy Of Cognitive Training For Mild And Moderate Alzheimer's Disease:a Meta-analysis

Background and Objective:Alzheimer's disease,also known as Alzheimer's disease,is the most common type of dementia and is the fourth major disease that threatens the health of the elderly.AD is currently treated by drug therapy,drug therapy mainly includes: cholinesterase inhibitors,such as: donepezil,galantamine;NMDA receptor antagonist,on behalf of drugs: memantine;calcium antagonists,such as nimodipine and flunarizine;neuroprotective drugs,such as butylphthalide;also Chinese medicine treatment,such as Ginaton etc..At present,AD drugs mostly improve the clinical symptoms of patients,but can not fundamentally reverse the course of the disease,and some patients can not tolerate drug-related side effects.In recent years,AD's nonpharmacologic treatments(NPT)have attracted more and more attention.At present,NPT mainly include psychotherapy,3R therapy,reminiscence therapy,music therapy and cognitive function training.AD occult onset,early in recent memory decline as the main clinical manifestations,often neglected by clinical,therefore early intervention of AD plays an important role in the strategy for the treatment of this disease,NPT mainly benefit people with mild and moderate AD.A number of clinical studies have confirmed the drug combined with cognitive training can improve the treatment of mental patients with cognitive function,slowing the progression of speed,but because of the number of samples in clinical research,clinical trial time is short,the evidence-based level is not high,and the daily life ability of patients to improve the conclusions are inconsistent.In this study,Meta analysis was conducted by measuring the outcome of cognitive function training and drug therapy in patients with mild to moderate AD,providing a higher level of evidence-based medical evidence for its clinical application.Methods:A computer retrieval and manual retrieval from January 2000 to January 2017 during a cognitive training in the treatment of Alzheimer's disease literature by defining key words,according to the inclusion and exclusion criteria selected high quality standards have been developed in the literature English,after reading the article does not conform to the requirements of the document,extract the effective amount of each evaluation results of common AD table of cognitive training and drug treatment in to meet the requirements of the literature,including the commonly used scale: MMSE(Mini-mental State Examination,MMSE),ADL(activities of daily learning,ADL),instrumental activities of daily living scale(instrumental activities of daily learning,IADL),Alzheimer's disease assessment scale cognitive subscale(Alzheimer 's disease assess Ment Scale-Cognitive subscale,ADAS-Cog),Hamilton Anxiety Scale(Hamilton Anxiety Scale,HAMA)and the Hamilton Depression Scale(Hamilton Depression Scale,HAMD),using Revman5.3 software Meta to carry on the analysis,and the analysis of domestic and foreign scores were calculated,the ratio of ratio(OR)value,mean difference(MD),standard deviation(SD)and 95% confidence intervals(95%CI),Z test.P<0.05 is statistically significant in this study.Results:The results showed that compared with the control group,the total scores of MMSE increased significantly,and the scores of ADAS-Cog,HAMD and HAMA decreased significantly,and the difference was statistically significant(P<0.05).The total scores of ADL and IADL were not significantly different(P>0.05).Conclusion:Effect of cognitive function training in the treatment of AD is effective,which can delay the progress of the course of AD,improve the state of mental patients,delaying cognitive dysfunction in patients with the occurrence and development process,improve the anxiety and depression status of patients,patients with delayed personality and spirit change process,to improve the ability of daily life of patients is not obvious.The cognitive training operation requires professional medical personnel or personnel trained to give patients treatment rules,training system,so the feasibility of promotion and a wide range of high quality still needs more evidence of further guidance.