nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2018-4-81-87nnp-1001Research ArticleORIGINAL INVESTIGATIONSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ И МЕТОДИКИCognitive and motor training for patients with moderate cognitive impairment and mild dementiaКогнитивно-моторный тренинг у пациентов с умеренными когнитивными нарушениями и легкой деменциейНауменкоА. А.NaumenkoA. A.

Кафедра нервных болезней и нейрохирургии лечебного факультета.

119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine

11, Rossolimo St., Build. 1, Moscow 119021

ПреображенскаяИ. С.PreobrazhenskayaI. S.

Ирина Сергеевна Преображенская - кафедра нервных болезней и нейрохирургии лечебного факультета.

119021, Москва, ул. Россолимо, 11, стр. 1

Irina Sergeevna Preobrazhenskaya - Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine.

11, Rossolimo St., Build. 1, Moscow 119021

irinasp2@ya.ruФГАОУВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава России, Москва, РоссияРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation2018141220181048187Copyright © Naumenko A.A., Preobrazhenskaya I.S., 20182018Науменко А.А., Преображенская И.С.Naumenko A.A., Preobrazhenskaya I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1001Objective

Objective: to investigate the effectiveness of cognitive and motor training as an additional method to basic therapy in patients with Alzheimer's disease (AD) and vascular cognitive impairment (VCI).

Patients and methods

Patients and methods. The investigation enrolled 41 patients (15 women and 26 men; mean age. 73.59+6.3 years), including 32 patients with AD (mean age 74.94+5.15 years) and 9 patients with VCI (mean age, 72.31+4.98 years). Cognitive impairment (CI) corresponded to mild dementia in 15patients (5 women and 10 men; mean age 74.6+2.8years) and to moderate dementia in 29 (10 women and 19 men; mean age 72.1+3.2 years). The patients were randomly assigned to individual, group, and mixed (individual and then group) cognitive training groups. Quantitative scales were used to assess changes in CI and emotional and behavioral disorders after 1.5, 3, and 6 months of therapy.

Results and discussion

Results and discussion. During cognitive and motor training, all the groups showed a significant decrease in the severity of CI (p < 0.05), depression, anxiety, and apathy. The effectiveness of the training was further influenced by the severity of concomitant cardiovascular disease, the degree of apathy, adherence to the training, and the early initiation of basic symptomatic therapy.

The greatest positive changes in anxiety and depressive disorders were noted in the patients receiving group cognitive and motor training.

Conclusion

Conclusion. The results of the investigation allow group cognitive and motor training to be recommended as a mainstay in the therapy of patients with CI concurrent with emotional disorders.

Цель исследования — изучение эффективности когнитивно-моторного тренинга в качестве дополнительного метода к базисной терапии у пациентов с болезнью Альцгеймера (БА) и сосудистыми когнитивными нарушениями (СКН).

Пациенты и методы

Пациенты и методы. В исследование включен 41 пациент (15 женщин и 26 мужчин, средний возраст 73,59+6,3 года), из них 32 пациента с БА (средний возраст 74,94+5,15 года) и 9 с СКН (средний возраст 72,31+4,98 года). У15 пациентов (5 женщин и 10мужчин, средний возраст 74,6+2,8 года) когнитивные нарушения (КН) соответствовали степени легкой деменции и у 29 (10женщин и 19 мужчин, средний возраст 72,1+3,2 года) — умеренной степени. Пациентов случайным образом распределяли в группы индивидуального, группового (ГКТ) и смешанного (индивидуальный, а затем групповой) когнитивного тренинга. С помощью количественных шкал оценивали динамику КН, эмоциональных и поведенческих расстройств через 1,5; 3 и 6 мес терапии.

Результаты и обсуждение

Результаты и обсуждение. На фоне когнитивно-моторного тренинга во всех группах отмечалось достоверное уменьшение выраженности КН(p<0,05), депрессии, тревоги и апатии. На эффективность тренинга оказывали дополнительное влияние выраженность сопутствующей сердечно-сосудистой патологии, степень апатии, приверженность тренингу, а также раннее начало базисной симптоматической терапии. Наибольшая положительная динамика тревожно-депрессивных расстройств отмечена у пациентов, получавших ГКТ.

Заключение

Заключение. Результаты исследования позволяют рекомендовать ГКТ как основной для лечения пациентов с сочетанием КН и эмоциональных расстройств.

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The authors declare that there are no conflicts of interest present.