家庭医生制服务模式对老年轻度认知功能障碍干预效果的研究  

Evaluation general practitioner system service mode on mild cognitive impairment elderly patients

作　　者：方红 盛建华[2] 邱朝晖[3] 

机构地区：[1]长宁区周家桥街道社区卫生服务中心,上海市200051 [2]上海市精神卫生中心精神科,上海市200030 [3]复旦大学附属华东医院心内科,上海市200040

出　　处：《老年医学与保健》2015年第2期115-118,共4页Geriatrics & Health Care

基　　金：上海市长宁区卫生和计划生育委员会课题(20114S14001)

摘　　要：目的 探讨家庭医生制服务模式对老年人轻度认知功能障碍干预的方法和效果.方法 对上海市周家桥社区随机取样抽取的1 059例60岁以上老人进行调查,有137例患有轻度认知功能障碍,随机分为干预组70例,对照组67例;以家庭医生制服务模式对干预组70例进行为期2年的干预.干预方法：每月1次的定期健康宣教,每2w1次上门督促记忆力训练,培养良好生活习惯和心理抚慰等.采用简易精神状况检测量表（MMSE）、日常生活活动能力量表（ADL）对各组进行干预前后的认知功能测试和活动能力评定.结果 经过2年的干预,干预组较对照组MMSE评分（26.73 ±2.30）vs（24.94± 1.51）,差异有统计学意义（P＜0.05）,ADL评分（16.28±1.47）vs （14.92±1.64）,差异有统计学意义（P＜0.05）.干预组70例有6例转化为痴呆,转化率为8.57％,对照组67例有9例发展为痴呆,转化率为13.43％,差异有统计学意义（P＜0.05）.结论 家庭医生制服务模式干预对老年轻度认知功能障碍人群能有效改善患者的认知功能,延缓痴呆的发生.Objective To evaluate general practitioner system service mode on mild cognitive impairment elderly pa- tients. Methods Among randomly chose 1 059 elderly over 60 years old patients in Zhoujiaqiao community, 137 diagnosed as mild cognitive impairment （MCI）, were randomly divided into intervention group （70 cases） and control group （67 cases）. Interventions were conducted for 2 years to the MCI patients, The intervention included monthly healthy instruction, every 2 weeks memory training, habits nurturance and psychology treatment. Mini mental state examination （MMSE）, ac- tivities of daily living scale （ADL） and clinical dementia rating （CDR） were used for evaluating and rating before and after the interventions. Results After 2 years intervention, MMSE scores of intervention group were （ 26.73 ±2.30 ） and that of control group were （ 24.94 ± 1.51 ）, P 〈 0.05. ADL scores of intervention group were （ 16.28 ± 1.47 ） and of control group were （ 14.92± 1.64）, P〉0.05. Six patients in intervention group were developed to dementia, the conversion rate was 8.57 %, but 9 patients in control group, the conversion rate was 13.43 % （P 〈 0.05）. There were significant differences of MMSE and ADL before and after intervention in both two groups （P〈0.05）. Conclusion MCI elderly patients should be given positive intervention in community. Community intervention for elderly patients with MCI may improve and enhance cognitive function, furthermore delay deteriorating to Alzheimer＇s disease.

关 键 词：家庭医生制 轻度认知障碍 干预 

分 类 号：R749.16[医药卫生—神经病学与精神病学]