Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8133
Peer-review started: January 14, 2022
First decision: April 8, 2022
Revised: April 27, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Processing time: 198 Days and 19.5 Hours
Intervention research on early Alzheimer's disease (AD) has been a hot spot in the study of cognitive impairment and dementia in recent years. With the accelerating pace of global population aging, the attention on all aspects of AD has greatly increased. Based on the principles of cognitive neuroscience and cognitive psychology, according to the relevant cognitive fields and main clinical manifestations of the main damage in the progress of AD, in combination with the characteristics of the cognitive decline of the elderly in China, an analysis of 60 elderly hospitalized patients with AD and long-term residents of the plateau was carried out. A scientific, systematic and multi-dimensional cognitive rehabilitation training method, which integrates six cognitive fields, namely, situational memory, executive function, working memory, attention processing, speech ability and reasoning judgment, was applied to these early-stage AD patients. Use of the standard cognitive training intervention mode for early-stage AD patients can improve their cognitive ability, improve their quality of life and slow development of the disease, which is of great clinical significance in reducing medical expenses and the economic burden of families and society.
This study integrated original cognitive rehabilitation tools in the six fields of episodic memory, executive function, working memory, processing speed, speech ability and reasoning judgment into an integrated comprehensive training platform to carry out a standardized intervention on pre-clinical AD patients, and verify the effectiveness of the intervention through cognitive behavior, daily living ability and other indicators. This localized intervention training system, scientific cognitive rehabilitation program and multi-dimensional efficacy evaluation has important innovative significance.
Our objective was to explore the effect of clinical nursing cognitive training on early AD patients at high altitude. The new intervention method of cognitive rehabilitation training improved the cognitive ability and daily living ability in early AD patients. This nursing intervention is a new nursing method. In addition to routine nursing, it can also improve patients' cognitive function, diet and drug guidance, memory, attention, logical thinking, orientation and abstract thinking. Therefore, we suggest that this method should be applied in future clinical practice to improve cognitive dysfunction and quality of life in early AD patients.
This study included consecutive early AD patients who were treated in the Department of Geriatrics of Qinghai Provincial People's Hospital from August 2019 to March 2021. A prospective randomized controlled trial design was used in this study. Sixty patients were randomly divided into two groups, the cognitive training group and the control group, with 30 patients in each group. The short-term and long-term effects of cognitive rehabilitation training on pre-clinical AD were evaluated during 52 wk of cognitive training intervention and 26 wk of long-term follow-up. All data were analyzed by SPSS 22.0 software (IBM Corp., Armonk, NY, United States). Quantitative data were expressed as mean ± SD, and the t-test was used to compare the differences between the two groups. P < 0.05 was considered statistically significant.
With the development of AD, many advanced cognitive functions such as attention, memory, orientation, language ability, reasoning ability and related functions such as housekeeping, financial management, dressing, bathing and physical activities decrease, resulting in poor prognosis, decreased abilities of daily living, decreased quality of life, increased caregiver burden and medical expenses. In early AD patients, the standard cognitive training intervention mode can improve patients' cognitive ability, improve their quality of life, slow development of the disease, reduce medical costs, and reduce the economic burden on society and families.
This study showed that the online rehabilitation training method is simple and easy to operate, and has the training integral function, which can improve the training interest and compliance of patients. A summary of current knowledge provided by this study was used to establish a cognitive rehabilitation training platform, using at least 20 sets of rehabilitation training tools covering the six cognitive domains of episodic memory, executive function, working memory, processing speed, speech ability and reasoning judgment. We used a prospective clinical trial design to carry out the intervention on pre-clinical AD patients, establish scientific cognitive training process specifications, and develop clinical cognitive and other multi-index systems to evaluate the efficacy of cognitive rehabilitation training, and then build a comprehensive and effective cognitive rehabilitation system for pre-clinical AD. The effect of cognitive rehabilitation training was evaluated according to the clinical activities of daily living and neuropsychological scales before and after the intervention. The new scientific, systematic and multi-dimensional cognitive rehabilitation training method was used to assess early AD patients from the plateau area. The results can determine the degree of rehabilitation in patients, and screen patients' cognitive tests according to the brain health management platform, which improves the accuracy of screening in early AD patients. This study found that the management platform can directly monitor the training of patients, which is conducive to tracking and data management. This study showed that cognitive rehabilitation training should be used in clinical practice in the future. The application of modern information-based methods in clinical nursing has resulted in improved work efficiency.
This study was carried out in Qinghai Provincial People's Hospital, with a small sample size and limited analysis. In future research, further standardization of the implementation process of cognitive training should be performed, to reveal the deep-seated brain neural mechanism of training in improving cognition and living ability. This would allow the formulation of more scientific cognitive training programs for different groups, incorporate more comprehensive and quantitative effect evaluation indicators, establish and promote the evaluation system of cognitive training based on neuroimaging indicators, and provide reference for research in this field. The content and form of training can be based on the actual life of patients and their own needs, and consider the application scenarios in different environments such as hospitals, families and nursing homes, in order to better transfer the training and research results to daily life.