互动式歌唱表演对轻中度阿尔茨海默病患者抑郁、精神行为和运动训练参与率的影响

目的 观察互动式歌唱表演对轻中度阿尔茨海默病（AD）患者抑郁、精神行为症状及运动训练参与率的影响。方法 选取符合入组条件≥60周岁AD患者63例，随机分为研究组（31例）和对照组（32例）。所有受试患者常规药物治疗及常规运动训练，对照组接受被动性音乐治疗，研究组接受以互动歌唱为主的主动性音乐治疗，1次/d，每次1小时，每周训练5天，持续干预6个月。于治疗前、治疗1个月后、治疗3个月后、治疗6个月后分别采用康奈尔痴呆抑郁量表（CSDD）评分、阿尔茨海默病病理行为（BEHAVE AD）评分、参与率进行评估。结果 治疗1个月、3个月后，研究组CSDD评分较治疗前均降低（P<0.05）；治疗6个月后，研究组患者CSDD评分较治疗前、治疗1个月、3个月后均显著降低（P<0.05），且与对照组比较差异有统计学意义（P<0.05）。治疗1个月、3个月后，研究组BEHAVE AD评分较治疗前均降低（P<0.05）；治疗6个月后，研究组患者BEHAVE AD评分较治疗前、治疗1个月、3个月后均显著降低（P<0.05），且与对照组比较差异有统计学意义（P<0.05）。治疗6个月后，两组运动训练参与率组间比较差异有统计学意义（P<0.05）。结论 互动式歌唱表演可能对改善轻中度AD患者的抑郁和精神行为症状有着积极的疗效，同时对提高受试者运动训练的参与率可能有着更积极的疗效。

Impact of interactive singing performance on depression,psychobehavioral symptoms and rate of participation in exercise training in patients with mild to moderate Alzheimer's disease

Objective To observe the effects of interactive singing performance on depression, psychobehavioral symptoms and rate of participation in exercise training in patients with mild to moderate Alzheimer's disease (AD). Methods Sixty three patients with AD who met the inclusion criteria ≥60 years old were randomly divided into study group (31 cases) and control group (32 cases). All patients received routine drug therapy and regular exercise training. The control group received passive music therapy. The study group received active music therapy mainly based on interactive singing. Both groups were trained for 1 time/d, 1 hour each time, 5 days per week, and the intervention continued for 6 months. The score of Cornell Dementia Depression Scale (CSDD), Alzheimer's Disease Pathological Behavior (BEHAVE AD) and the participation rate were assessed before treatment, 1 month, 3 months after treatment and 6 months after treatment, respectively. Results After 1 month and 3 months of treatment, the CSDD scores in study group were lower than those before treatment(P<0.05). After 6 months of treatment, the CSDD scores in study group were significantly lower than those before treatment, 1 month and 3 months after treatment (P<0.05), and the difference had statistic significance compared with the control group (P<0.05). After 1 month and 3 months of treatment, the BEHAVE AD scores in study group were lower than those before treatment (P<0.05). After 6 months of treatment, the BEHAVE AD scores in study group were significantly lower than those before treatment, 1 month after treatment and 3 months after treatment (P<0.05), and the difference showed significance between two groups (P<0.05). After 6 months of treatment, there was significant difference between two groups in terms of the participation rate of exercise training (P<0.05). Conclusion Interactive singing performance may have positive effect on improving depression and psychobehavioral symptoms in patients with mild to moderate AD, and may have more positive effect on improving participants' participation in exercise training.