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Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment A cross-sectional study

萬屋京典広島大学

2021.03.23

概要

Many people with cognitive impairment (CI) are eventually
admitted to a nursing home (NH),[1,2] and it has been reported
that cognitive function tends to decline over time these patients.[2]
Furthermore, cognitive deterioration of NH residents with CI
may lead to behavioral disorders such as agitation and aggressive
behavior.[3–5] CI may also be related to an increased risk of
developing a disability.[6] This could incur major physical,
mental, and economic burdens for people with CI and their
caregivers, and, from a social point of view, increase the cost of
medical, and nursing care.[7,8] Improving the cognitive function
of NH residents with CI may help solve these problems; however,
this remains challenging.
Risk factors for CI include older age, female gender, less
education, not being married, a lack of physical, and cognitive
activities, and a lack of activities of daily living (ADL) due to
disability.[9,10] However, it is difﬁcult for NH residents with CI to
intervene in risk factors such as age, gender, educational
background, and marital status.
One intervention that has been reported to improve the
cognitive function of NH residents with CI is a pharmacological
intervention.[11,12] However, pharmacological interventions are
not sufﬁcient to improve cognitive function, and, at the same
time, have adverse side effects such as weight loss, lower limb
cramps, and increased mortality.[13–17] Therefore, the further
development of non-pharmacological intervention (NPI), which
is expected to have the same beneﬁcial effects as pharmacological
intervention, is required.[18,19]
In NPIs targeting the cognitive function of people with CI,
improvements using a single intervention such as reminiscence,
music, and cognitive training, have been studied.[20–22] In recent
years, it has been reported that multimodal non-pharmacological
intervention (MNPI) can be expected to improve more global and
speciﬁc cognitive functions than NPI alone.[23]
Our systematic review reported that MNPI, which combines
exercise, cognitive intervention, and practice in ADL, may be
effective in improving global cognitive function, executive
function, attention, memory, and structural apraxia in NH
residents with CI.[23] However, the characteristics of global and
speciﬁc cognitive functions of NH residents with CI in whom NPI
in the form of MNPI can be carried out remain unknown, and no
study has addressed this to date. As such, effective implementation strategies for MNPI, such as the order of provisions and
considerations of each NPI according to the state of cognitive
function of NH residents with CI, have not yet been studied.
In previous studies on people with CI, analyses using tests and
maximum likelihood estimations have primarily been used as
conventional statistical methods.[24,25] However, the interpretation of the results of conventional statistical methods is not
intuitive, and overﬁtting is frequently carried out in analyses that
combine several types of probability distributions to reﬂect
background information and hypotheses. ...

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参考文献

[1] Smith GE, Kokmen E, O’Brien PC. Risk factors for nursing home

placement in a population-based dementia cohort. J Am Geriatr Soc

2000;48:519–25.

[2] Wilson RS, McCann JJ, Li Y, et al. Nursing home placement, day care

use, and cognitive decline in Alzheimer’s disease. Am J Psychiatry

2007;164:910–5.

[3] Cohen-Mansﬁeld J, Marx MS, Rosenthal AS. Dementia and agitation in

nursing home residents: how are they related? Psychol Aging 1990;5:3–8.

Author contributions

Data curation: Kyosuke Yorozuya, Hideaki Hanaoka.

Yorozuya et al. Medicine (2020) 99:37

Medicine

[4] Fernández M, Gobartt AL, Balañá M. Behavioural symptoms in patients

with Alzheimer’s disease and their association with cognitive impairment. BMC Neurol 2010;10:1–9.

[5] Abrahamson K, Clark D, Perkins A, et al. Does cognitive impairment

inﬂuence quality of life among nursing home residents? Gerontologist

2012;52:632–40.

[6] Shimada H, Makizako H, Doi T, et al. Cognitive impairment and

disability in older Japanese adults. PLoS One 2016;11:e0158720.

[7] Kamiya M, Sakurai T, Ogama N, et al. Factors associated with increased

caregivers’ burden in several cognitive stages of Alzheimer’s disease.

Geriatr Gerontol Int 2014;14(Suppl 2):45–55.

[8] WHO [Internet]. Dementia. [Cited 19 September 2019]. Available from:

https://www.who.int/news-room/fact-sheets/detail/dementia.

[9] Rodríguez-Sánchez E, Mora-Simón S, Patino-Alonso MC, et al.

Prevalence of cognitive impairment in individuals aged over 65 in an

urban area: DERIVA study. BMC Neurol 2011;11:147.

[10] Kuang W, Gao M, Tian L, et al. Trends in the prevalence of cognitive

impairment in Chinese older adults: based on the Chinese longitudinal

healthy longevity survey cohorts from 1998 to 2014. Int Health

2020;00:1–10.

[11] Winblad B, Jones RW, Wirth Y, et al. Memantine in moderate to severe

Alzheimer’s disease: a meta-analysis of randomised clinical trials.

Dement Geriatr Cogn Disord 2007;24:20–7.

[12] Jelic V, Haglund A, Kowalski J, et al. Donepezil treatment of severe

Alzheimer’s disease in nursing home settings. A responder analysis.

Dement Geriatr Cogn Disord 2008;26:458–66.

[13] Loy C, Schneider L. Galantamine for Alzheimer’s disease and mild

cognitive impairment (review). Cochrane Database Syst Rev 2006;1:

CD001747.

[14] Raschetti R, Albanese E, Vanacore N, et al. Cholinesterase inhibitors in

mild cognitive impairment: a systematic review of randomised trials.

PLoS Med 2007;4:1818–28.

[15] Sadowsky CH, Galvin JE. Guidelines for the management of cognitive

and behavioral problems in dementia. J Am Board Fam Med

2012;25:350–66.

[16] Cooper C, Li R, Livingston G. A systematic review of treatments for mild

cognitive impairment. Br J Psychiatry 2013;203:255–64.

[17] Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention,

intervention, and care. Lancet 2017;390:2673–734.

[18] Graessel E, Stemmer R, Eichenseer B, et al. Non-pharmacological,

multicomponent group therapy in patients with degenerative dementia: a

12-month randomized, controlled trial. BMC Med 2011;9:1–1.

[19] Kurz AF, Leucht S, Lautenschlager NT. The clinical signiﬁcance of

cognition-focused interventions for cognitively impaired older adults: a

systematic review of randomized controlled trials. Int Psychogeriatr

2011;23:1364–75.

[20] Woods B, Spector AE, Jones CA, et al. Reminiscence therapy for

dementia. Cochrane Database Syst Rev 2005;2:CD001120.

[21] Olazarán J, Reisberg B, Clare L, et al. Nonpharmacological therapies in

Alzheimer’s disease: a systematic review of efﬁcacy. Dement Geriatr

Cogn Disord 2010;30:161–78.

[22] Vasionyte I, Madison G. Musical intervention for patients with

dementia: a meta-analysis. J Clin Nurs 2013;22:1203–16.

[23] Yorozuya K, Kubo Y, Tomiyama N, et al. A systematic review of

multimodal non-pharmacological interventions for cognitive function in

older people with dementia in nursing homes. Dement Geriatr Cogn

Disord 2019;48:1–6.

[24] Regier NG, Hodgson NA, Gitlin LN. Characteristics of activities for

persons with dementia at the mild, moderate, and severe stages.

Gerontologist 2017;57:987–97.

[25] Klapwijk MS, Caljouw MA, Pieper MJ, et al. Characteristics

associated with quality of life in long-term care residents with dementia:

a cross-sectional study. Dement Geriatr Cogn Disord 2016;42:

186–97.

[26] Gelman A. Bayesian Dara Analysis. Third Edition. Chapman and Hall/

CRC; 2013.

[27] Folstein MF, Folstein SE, McHugh PR. Mini-mental state”. A practical

method for grading the cognitive state of patients for the clinician. J

Psychiatr Res 1975;12:189–98.

[28] Sugishita M. Mini Mental State Examination-Japanese (MMSE-J). 2019;

Nihon Bunka Kagakusha Co., Ltd, PAR, Inc,

[29] Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the

staging of dementia. Br J Psychiatry 1982;140:566–72.

[30] Wiederman MW, Morgan CD. The neurobehavioral cognitive status

exam (NCSE) with geriatric inpatients. Clin Gerontologist 1995;15:

37–41.

[31] Matsuda O, Nakatani M. Manual for Japanese version of the

Neurobehavioral Cognitive Status Examination (COGNISTAT). Tokyo:

World Plan; 2004.

[32] Yamanaka K, Kawano Y, Noguchi D, et al. Effects of cognitive

stimulation therapy Japanese version (CST-J) for people with dementia: a

single-blind, controlled clinical trial. Aging Ment Health 2013;17:

579–86.

[33] Chalfont G, Milligan C, Simpson J. A mixed methods systematic review

of multimodal non-pharmacological interventions to improve cognition

for people with dementia. Dementia 2018;19:1–45.

[34] Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md

State Med J 1965;14:61–5.

[35] Kruschke JK. Bayesian estimation supersedes the t test. J Exp Psychol

Gen 2013;142:573–603.

[36] Kruschke JK. Doing Bayesian Data Analysis a Tutorial with R, JAGS,

and Stan Editon 2. Amsterdam, Boston, Heidelberg, London, New York,

Oxford, Paris, San Diego, San Francisco, Singapore, Sydney, Tokyo;

Academic Press is an imprint of Elsevier. 2015.

[37] Ozechowski TJ, Empirical Bayes MCMC. estimation for modeling

treatment processes, mechanisms of change, and clinical outcomes in

small samples. J Consult Clin Psychol 2014;82:854–67.

[38] Gelman A. Prior distributions for variance parameters in hierarchical

models (comment on article by Browne and Draper). Bayesian Anal

2006;1:515–33.

[39] Polson NG, Scott JG. On the half-cauchy prior for a global scale

parameter. Bayesian Anal 2012;7:887–902.

[40] Kyougoku M, Teraoka M. Bayesian analysis of the relationship between

belief conﬂict and occupational dysfunction. Am J Occup Ther

2019;73:7306205040p1-7306205040p9.

[41] Kawashima R. Mental exercises for cognitive function: clinical evidence.

J Prev Med Public Health 2013;46(Suppl 1):S22–7.

[42] Bahar-Fuchs A, Martyr A, Goh AM, et al. Cognitive training for people

with mild to moderate dementia. Cochrane Database Syst Rev 2019;3:

CD013069.

[43] Liang JH, Xu Y, Lin L, et al. Comparison of multiple interventions for

older adults with Alzheimer disease or mild cognitive impairment: a

PRISMA-compliant network meta-analysis. Medicine (Baltimore)

2018;97:e10744.

[44] Jia RX, Liang JH, Xu Y, et al. Effects of physical activity and exercise on

the cognitive function of patients with Alzheimer disease: a metaanalysis. BMC Geriatr 2019;19:181.

[45] de Souto Barreto P, Cesari M, Denormandie P, et al. Exercise or social

intervention for nursing home residents with dementia: a pilot

randomized, controlled trial. J Am Geriatr Soc 2017;65:E123–9.

...

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Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment A cross-sectional study

概要

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