石杉碱甲治疗轻度认知功能障碍疗效观察

目的采用石杉碱甲对轻度认知功能障碍(mild cognitive impairment,MCI)患者进行干预治疗,观察其服药后的认知功能改变。方法入选47例MCI患者随机分成两组,治疗组24例,对照组23例;两组均维持既往基础用药,治疗组在此基础上每日口服石杉碱甲0.2mg连续12周。两组患者用药前后均行简易精神状态检查量表(MMSE)评定认知功能状况,并进行P300检查。结果治疗后治疗组MMSE评分提高,与对照组相比差异有显著意义(均P<0.05);治疗组P300潜伏期缩短,同对照组相比有显著意义(P<0.05)。结论石杉碱甲能够改善MCI患者的认知功能。     

认知功能训练结合日常生活能力训练对阿尔茨海默病患者的影响

目的 探讨认知功能训练结合日常生活能力训练治疗阿尔茨海默病患者的效果。方法 选取2020年1月至2021年1月期间华中科技大学协和深圳医院老年医学科收治的160例阿尔茨海默病患者作为研究对象,采用随机数字表法将患者分为对照组和试验组,各80例。对照组患者进行常规护理干预,试验组患者在此基础上进行认知功能训练结合日常生活能力训练,分别采用简易智能精神状态检查量表（MMSE）和Barthel指数评定量表（BI）评估两组患者干预前后认知功能和日常生活能力的变化,比较两组患者干预前后阿尔茨海默病病理行为评定量表（BEHAVE-AD）与患者的训练/干预效果。结果 干预前,两组患者MMSE评分和BI评分比较,差异无统计学意义（P>0.05）;干预6个月后,两组患者MMSE评分和BI评分高于干预前,且试验组高于对照组,差异有统计学意义（P<0.05）;干预前,两组患者BEHAVE-AD评分比较,差异无统计学意义（P>0.05）;干预6个月后,两组患者BEHAVE-AD评分低于干预前,且试验组低于对照组,差异有统计学意义（P<0.05）;试验组患者训练总有效率优于对照组,差异有...     

认知护理干预对脑梗死轻度认知障碍患者认知功能的影响

目的对认知护理干预对脑梗死轻度认知障碍患者认知功能的影响进行初步研究。方法选取2017年1月～2018年10月我院收治的脑梗死轻度认知障碍患者90例,随机分两组,观察组45例和对照组45例。对照组采取常规治疗和护理,观察组在对照组的基础上给予认知护理干预。通过比较干预后两组患者的MMSE与ADL评分,比较两组的认知功能及精神状态的区别。结果观察组与对照组比较,干预前两组MMSE评分比较,差异无统计学意义(P 0.05),干预后观察组MMSE评分明显高于对照组,差异有统计学意义(P 0.05);观察组与对照组比较,干预前两组ADL评分比较,差异无统计学意义(P 0.05),干预后观察组ADL评分明显低于对照组,差异有统计学意义(P 0.05)。结论认知护理干预对脑梗死轻度认知障碍患者认知功能及精神状态有明显的改善,对于缓解脑梗死患者的认知障碍具有重要的临床参考价值,值得在医院推广应用。     

有氧运动联合正念训练对老年认知障碍患者认知功能的影响

目的探讨有氧运动联合正念训练对老年认知障碍患者认知功能的影响。方法选取2017年6月~2018年4月间我院老年科住院治疗的阿尔茨海默病患者60例为研究对象,随机分成两组。对照组(30例)给予12周有氧运动护理干预,观察组(30例)在对照组基础上联合正念认知训练(8周)干预,比较两组患者不同时间MMSE及ADAS-cog评分、NPI评分、ADCS-ADL评分,并分析干预方法安全性及患者满意度。结果两组所有患者均完成12周有氧运动及正念训练。两组患者第8、16周MMSE及ADAS-cog评分、NPI评分、ADCS-ADL评分均得到显著改善(P 0.05);观察组第8、16周MMSE评分明显高于对照组,ADAS-cog评分、NPI评分及ADCS-ADL评分均明显低于对照组,差异均有统计学意义(P 0.05);观察组总满意度(93.33%)明显高于对照组(73.33%),差异有统计学意义(P 0.05);两组患者干预期间未出现心电图及血、尿、便常规、肝功能、血生化异常;观察组及对照组均在第1周有氧运动中出现1例头晕患者。结论有氧运动联合正念训练可有效改善老年阿尔茨海默病患者认知功能,为老年阿尔茨海默病患者临床治疗提供一种有效的非药物治疗方案。     

计算机辅助认知训练对脑卒中患者认知功能的影响

目的：探讨计算机辅助认知训练在脑卒中患者认知功能恢复中的作用。方法将72例符合要求的患者随机分成实验组（n ＝36）及对照组（n ＝36）,两组患者均给予神经内科药物治疗、常规康复治疗,对照组同时给予传统人工认知训练,而实验组给予计算机辅助认知障碍训练,总治疗时间为8周。于训练后采用简明精神状态检查量表（MMSE）及洛文斯顿作业疗法认知评定成套测验（LOTCA）进行疗效评价。结果训练前两组患者 MMSE 及 LOTCA 评分无统计学差异（P ＞0．05）。训练后两组患者 MMSE 及 LOTCA 评分均较前提高（P ＜0．05）,与对照组相比,实验组 MMSE 及 LOTCA 评分提高更明显（P ＜0．05）。结论计算机辅助认知训练更有助于改善脑卒中患者认知功能。     

丁苯酞治疗老年轻度认知功能障碍患者的临床疗效及脑电功能评价

目的探讨丁苯酞治疗老年轻度认知功能障碍(MCI)患者的临床疗效及脑电功能评价。方法选取90例老年MCI患者。随机分为丁苯酞治疗组和对照组,观察2组患者治疗前后简易精神状况检查量表(MMSE)评分及事件相关电位P300的改变,评估临床疗效。结果治疗后治疗组患者与治疗前及对照组比较,MMSE分值提高(P<0.01),P300潜伏期均有缩短、波幅增高(P<0.05)。结论丁苯酞治疗能显著改善老年MCI患者认知功能及脑电活动状态。     

早期干预对早期老年性痴呆患者认知功能的影响

目的 探讨早期干预对早期老年性痴呆患者认知功能的影响.方法 64例早期老年性痴呆患者随机分为观察Ⅰ组和观察Ⅱ组,每组32例,并取30例体检正常老年志愿者作为对照组,应用简易精神状况检查表(MMSE)对三组患者进行测评,研究组1组给予早期干预,观察Ⅱ组给予常规护理,6个月后应用MMSE量表再次对患者进行测评.结果 观早期干预前,观察Ⅰ组与观察Ⅱ组MMSE总分及各项评分差异均无统计学意义(均P＞0.05),观察Ⅰ组、观察Ⅱ组MMSE总分及各项评分除物体命名外均低于对照组(t=2.374、2.531、2.278、2.286、2.428、2.756、2.241、2.274、2.283、2.431、2.431、2.557、2.282、2.291、2.762、2.314、2.281、2.291、2.610、2.271,均P＜0.05).进行干预6个月后,观察Ⅰ组在时间定向、地点定向、注意与计算、语言即刻记忆、短程记忆、阅读理解、言语表达等项目评分均高于观察Ⅱ组(t =2.721、2.341、2.674、2.567、2.223、2.231、2.341,均P＜0.05).结论 早期老年性痴呆患者认知功能普遍存在不同程度的损害,对患者有针对性地进行训练和干预对于认知功能的提高有一定作用.     

手指操训练在老年轻度认知功能障碍患者中应用的疗效探讨

目的探讨手指操训练在老年轻度认知功能障碍患者中临床疗效和安全性,旨在为老年轻度认知功能障碍患者的规范治疗提供参考依据。方法选择2008年12月至2011年12月在我院内科住院治疗的70例轻度认知功能障碍患者为研究对象,运用随机数字表法将本研究入选患者分为对照组和观察组,对照组患者按照内科常规治疗,而观察组患者则在对照组治疗的基础上进行手指操训练,干预3个月,比较对照组和观察组患者MOCA、MMSE和ADL评分差异。结果入院时,对照组和观察组患者MOCA、MMSE和ADL评分差异无显著性(P>0.05);治疗3个月,对照组患者MOCA和MMSE评分低于观察组,而ADL评分高于观察组的,对照组和观察组在MOCA、MMSE和ADL评分方面差异有显著性(P<0.05),且治疗前后对照组和观察组患者在不良反应发生上差异无显著性(P>0.05)。结论手指操训练能够保持老年轻度认知功能障碍患者认知水平,延缓患者认知受损的进程,且能够提高或保持日常生活能力,值得进一步推广运用。     

根除幽门螺杆菌联合益生菌治疗对2型糖尿病患者轻度认知功能障碍的效果观察

摘要：目的:观察根除幽门螺杆菌（Hp）联合益生菌治疗对2型糖尿病（T2DM）患者轻度认知功能障碍（MCI）的治疗效果。方法:112例T2DM伴MCI患者,检测Hp为阳性,随机分为对照组和观察组各56例。对照组给予常规控制血糖治疗,疗程3个月;观察组在此基础上进行根除Hp联合益生菌治疗,疗程14 d。根除Hp疗程结束1个月后评价Hp根除率,比较两组患者治疗前和治疗3个月后的血糖（FBG、Hb A1c）、血清炎症因子（IL-1β、IL-6、TNF-α）水平变化,以及简易精神状态量表（MMSE）及蒙特利尔认知量表（MoCA）评分等认知功能变化。结果:观察组患者的Hp根除率为87.50%。治疗后,两组患者FBG、Hb A1c均较前显著降低（P<0.05）。观察组患者治疗后血清IL-1β、IL-6、TNF-α水平较前显著下降,MoCA、MMSE评分则较前显著升高（P<0.05）;且上述治疗均明显优于对照组（P<0.05）。结论:根除Hp联合益生菌治疗可改善T2DM伴MCI患者的认知功能,减轻炎性反应。     

延续性护理干预对缺血性脑卒中患者认知功能及日常生活能力的影响

目的 探讨延续性护理干预对缺血性脑卒中患者认知功能及日常生活能力的影响。方法 选择2018年10月至2019年12月东莞市松山湖中心医院神经内科住院的缺血性脑卒中患者122例,随机分为对照组和观察组,每组各61例,对照组采用常规护理干预,观察组在常规护理基础上采用延续性护理干预。采用简易智能状态检查量表(MMSE)评分进行认知功能评估,采用改良Barthel指数(MBI)测量残疾和日常生活能力,进行满意度调查,对比分析两组认知功能,日常生活能力及满意度。结果 出院后6个月,观察组MMSE评分、即刻记忆、注意力和计算力、回忆能力及语言能力明显高于对照组,差异有统计学意义(P 0.05)。出院前观察组MBI评分与对照组比较,差异无统计学意义(P 0.05)。与出院前比较,观察组和对照组出院后6个月MBI评分明显升高,差异有统计学意义(P 0.05)。观察组出院后6个月MBI评分明显高于对照组,差异有统计学意义(P 0.05)。观察组满意度明显高于对照组,差异有统计学意义(P 0.05)。结论 对缺血性脑卒中患者实施延续性护理干预,可明显改善其预后认知功能,提高患者日常生活能力及护理满意度。     

Neuropsychology of cognitive ageing, minimal cognitive impairment, Alzheimer's disease, and vascular cognitive impairment

In this review, the neuropsychological symptoms of different diseases in the elderly are described. After a brief explanation of relevant principles in the neuropsychological assessment of older individuals, a summary of the complex relation between ageing and cognition is presented. It may be concluded that cognitive decline is not an inevitable outcome of ageing, and may well be the result of unrecognised pathology. The term mild cognitive impairment is reserved for patients whose impairment is objectively demonstrable but is not pronounced in more than one domain of cognition and does not seriously affect activities of daily living. The initial phase of Alzheimer's disease is marked by a progressive deterioration of episodic memory. When the process advances, the impairment spreads to other functions, such as semantic memory, language and visuo-spatial ability. Vascular dementia is the second most common type of dementia; however, it is increasingly being recognised that vascular dementia is actually a heterogeneous syndrome and that several vascular pathologies can lead to cognitive deterioration. In contrast to the striking deficits produced by cortical infarcts, lesions of the subcortical white matter are mainly associated with a non-specific slowing of behaviour. Cerebrovascular disease also plays an important role in forms of cognitive decline other than dementia, and as such, it appears to be no less prevalent in old age than Alzheimer's disease. Neuropsychology is an important asset to the study and treatment of cognitive decline, but must be embedded in a multi-disciplinary context.     

认知功能训练改善轻度认知功能障碍的研究进展

阿尔茨海默病是最常见的神经系统退行性疾病之一,但其患者在达到痴呆症程度之前存在一定时期的轻度症状期,被称为阿尔茨海默病所致轻度认知功能障碍(mild cognitive impairment,MCI)阶段.不过,对MCI的治疗目前尚无统一的治疗原则或专家共识,且使用药物治疗MCI还存在一定的争议和风险.认知功能训练作为一种重要的非药物治疗手段,已逐渐成为早期干预认知功能减退的一种重要手段和研究热点.本文介绍对MCI患者进行认知功能训练的常用方式,具体论述了认知域和非认知域训练两种方法对MCI患者的认知功能和日常生活能力的影响,并讨论了认知功能训练效果的评估方法和训练设计的改良策略.     

Early markers of cognitive enhancement: developing an implicit measure of cognitive performance

There is intense interest in the development of effective cognitive enhancing drugs which would have therapeutic application across a number of neurological and psychological disorders including dementia, schizophrenia and depression. However, development in this area has been limited by the absence of sensitive biomarkers which can be used to detect and refine therapeutic-like action in phase 1 clinical studies. The aim of the present study was therefore to develop a measure of cognition relevant to the action of candidate cognitive enhancers which might be sensitive to pharmacological manipulation in healthy volunteers. Healthy volunteers (n?=?34) were randomised to receive a single dose of modafinil (100 mg) or placebo. Five hours post dose, attentional flexibility in learning was assessed using a novel implicit learning task. Volunteers also completed an auditory digit span task and visual analogue scales (VAS). Modafinil increased alertness as measured by the VAS. In the implicit learning task, modafinil enhanced learning rates in terms of both accuracy and reaction time, suggesting an increase in implicit rule learning. These results suggest that the novel learning task should be explored as a biomarker of early cognitive improvement which could be more sensitive than conventional measures.     

Non-pharmacological cognitive enhancement

The term "cognitive enhancement" usually characterizes interventions in humans that aim to improve mental functioning beyond what is necessary to sustain or restore good health. While the current bioethical debate mainly concentrates on pharmaceuticals, according to the given characterization, cognitive enhancement also by non-pharmacological means has to be regarded as enhancement proper. Here we summarize empirical data on approaches using nutrition, physical exercise, sleep, meditation, mnemonic strategies, computer training, and brain stimulation for enhancing cognitive capabilities. Several of these non-pharmacological enhancement strategies seem to be more efficacious compared to currently available pharmaceuticals usually coined as cognitive enhancers. While many ethical arguments of the cognitive enhancement debate apply to both pharmacological and non-pharmacological enhancers, some of them appear in new light when considered on the background of non-pharmacological enhancement. This article is part of a Special Issue entitled 'Cognitive Enhancers'.     

围术期认知护理对老年认知功能的影响

目的观察进行围术期认知护理对老年患者术后认知功能的影响。方法择期髋关节置换手术患者30例,年龄65～89岁,患者术前认知护理干预从术前3d开始,术后认知护理干预从术后1d开始,于术前1d、术后1d、3d记录MMSE评分。结果术后第1d有3例发生POCD(10%);与术前比较,术后第1天MMSE评分降低(P<0.05)。结论髋关节置换手术老年患者术后认知功能有改变;围术期认知护理对老年患者术后认知功能的影响不能确定。     

The cognitive underpinnings of addiction

A new conditional reasoning measure was developed to evaluate the role of implicit biases in perpetuating addictive behavior. Data (N = 669) were collected in 2005 from two samples in a suburban area: individuals with a known history of chemical dependency and individuals from the general population. Results indicated a strong correlation between overall test scores and group membership (r(pb) = .48), which increased when the groups' demographic characteristics were equalized (r(pb) = .65). Overall, findings suggest that addiction-prone individuals rely on a distinct set of cognitive biases that rationalize self-destructive behavior. The study's limitations are noted and implications and directions for future research are discussed.     

药物对认知功能损害的研究

诸多药物能损害认知功能,其作用有专一性,作用强弱与药物剂量、用药时间等因素有关.一个半世纪以来,有关药物与认知损害的关系一直足研究的热点.正确了解药物对认知功能的影响及其作用方式,对药物深入全而地认识,有利于更好地发挥药物的治疗作用.本文探讨药物与认知损害的关系,加深对影响认知功能约物的认识,对临床合理用药具有指导意义.     

Dopaminergic enhancement of cognitive function

The ascending dopamine system of the mammalian brain has been associated with motor, mnemonic and goal-directed or reward-related behaviour. The most progress in understanding the cortical mechanisms of dopaminergic modulation of function has been made with regards to short-term mnemonic (or working memory) function. Research in experimental animals strongly suggests that stimulation of dopamine D1 receptors in the prefrontal cortex can ameliorate spatial working memory related cognitive deficits, and may even enhance cognitive function in healthy animals. Research in humans has not been able to clearly replicate these findings, partly due to the lack of available agents that can safely be used. Low doses of dopamine D2 receptor agonists such as bromocriptine and pergolide may be able to enhance working memory and executive functions, but these effects may be dependent on the nature of the tasks used and the baseline performance levels of the subjects. Thus, the effects of dopaminergic cognitive enhancers may not be simple, or uniform across subjects. Systematic studies in humans carefully controlling task parameters are needed in order to specify the potential cognitive processes open to enhancement with dopaminergics. However, since the DA receptor subtypes in different brain regions appear to differentially influence similar functions, carefully defining the cognitive processes to be tested against potential therapeutics is an equally important goal. Studies in patients groups using selective dopaminergics are rather restricted, but show promise for designing large-scale clinical trials into the cognitive enhancing properties of potential therapeutic agents that act through the dopamine system.