DOI QR코드

DOI QR Code

Analysis of Effect of Non-drug intervention on the Elderly with Dementia in Korea: Meta-Analysis

국내 치매노인의 비약물적 중재에 대한 효과분석: 메타분석

  • Lee, Na Rae (Division of Emergency medical rehabilitation, Kangwon University) ;
  • Park, Yun Ji (Division of Emergency medical rehabilitation, Kangwon University) ;
  • Jang, Jong Sik (Division of Occupational Therapy, Kangwon University)
  • 이나래 (강원대학교 응급의료재활학과) ;
  • 박윤지 (강원대학교 응급의료재활학과) ;
  • 장종식 (강원대학교 작업치료학과)
  • Received : 2021.03.04
  • Accepted : 2021.04.02
  • Published : 2021.04.30

Abstract

This paper aims to guide experts who manage dementia by exploring the various non-drug interventions and analyzing the effective intervention methods applicable according to the functional level of the elderly with dementia. Fourteen studies were analyzed in this study. Meta-analysis was performed using the means, standard deviations, and the number of samples. Subsequent meta-analysis showed that the Holnis program had the largest effect size in cognitive function, the bakery activity program in memory, and the composite intermediation program with ADL was the largest. In addition, client-centric cognitive stimulation interventions showed the most significant effect sizes, while in depression and BPSD, rhythmic movement activities had the most significant effect size. Elderly with dementia exhibit various symptoms depending on their characteristics and the progress of the disease. Therefore, more efficient arbitration could be provided if the effects of each intervention can be applied differently.

본 연구는 치매노인에게 적용되고 있는 다양한 비약물적 중재 방법과 효과에 대해 알아보고, 치매의 임상적 증상에 따른 비약물적 중재의 효과성을 분석하여 치매노인을 치료하고 관리하는 전문가들에게 도움을 주고자 한다. 이를 위해 RISS를 비롯한 5개의 데이터베이스를 사용하여 치매노인의 비약물적 중재에 대한 연구들을 검색한 후, 선정 및 배제기준에 따라 14편의 연구들을 분석하였다. 대상자 특성과 연구 특성으로 나누어 코딩을 진행하였고, 공통되는 증상별로 분류하여 메타분석을 실시하였다. 공통되는 종속변수는 인지기능, 기억력, 일상생활수행능력, 삶의 질, 우울, 행동심리증상등 6개의 하위영역으로 분류되었으며, 메타분석 결과 인지기능에서는 홀니스 프로그램, 기억력에서는 제과제빵 활동, 일상생활수행능력에서는 복합중재 프로그램, 삶의 질에서는 클라이언트 중심적 인지자극치료, 우울과 행동심리증상에서는 리듬움직임 활동이 가장 효과가 좋은 것으로 나타났다. 본 연구결과를 보아 치매노인에게 적용되고 있는 비약물적 중재는 매우 다양하며 중재들이 나타내는 효과성에서도 서로 다른 차이를 나타내고 있음을 알 수 있었다. 따라서 증상별로 중재에 대한 효과의 차이를 구별하여 적용한다면 보다 효율적인 중재가 제공될 수 있을 것으로 사료된다.

Keywords

References

  1. M. U. Kim, "Definition and Diagnostic Approach for Dementia", Geriatric Rehabilitation, 4(1), pp.1-9, 2014.
  2. H. Cho and Z. K. Ko, "Current state of senile dementia and improvement of the long term care insurance for elderly people", Journal of the Korea Academia-Industrial cooperation Society, 13(12), pp.5816-5825, 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.12.5816
  3. A. Wino, L. Jonsson, A. Gustavsson, D. McDaid, D, K. Ersek, J. Georges, L. Gulacsi, K. Karpati, P. Kenigsberg and H. Valtonen, "The economic impact of dementia in Europe in 2008-cost estimates from the Eurocode project" I ternational Journal of Geriatrric Psychiatry, 26, pp.825-832, 2011. https://doi.org/10.1002/gps.2610
  4. S. T. Kim, "Past and Future of Drug Treatments for Alzheimer's Disease", Journal of Korean Neuropsychiatric Association, 57T(1), pp.30-42, 2018. https://doi.org/10.4306/jknpa.2018.57.1.30
  5. P. A. Newhouse, A. Potter, and E. D. Levin, "Nicotinic system involvement in Alzheimer's and Parkinson's disease", Drugs & aging, 11(3), pp.206-228, 1997. DOI: http://doi.org/10.2165/00002512-199711030-00005
  6. L. Parnetti, A. Lanari, S. Amici, V. Gallai, E. Vanmechelen, F. Hulstaert, and Phospho-Tau International Study Group, "CSF phosphorylated tau is a possible marker for discrimination Alzheimer's disease from dementia with Lewy bodies" Neurological Sciences, 22(1), pp.77-78, 2001. DOI: http://doi.org/10.1007/s100720170055
  7. GT. Buhr and KW. Heidi, "Difficult behaviors in long-term care patients with dementia", Journal of the American Mmedical Directors Association, 8, pp.101-103, 2007. DOI: http://doi.org/10.1016/j.jamda.2006.12.012
  8. C. F. Lippa, "Multisensory and other nonpharmaceutical approaches to dementia care", American Journal of Alzheimer's Disease & Other Demntias, 28(1), pp.5-6, 2013. DOI: http://doi.org/10.1177/1533317512473998
  9. M. W. Luijpen, E. J. Scherder, E. J. Van Sortieren, F. Swaab, and J. A. Sergeant, "Non-pharmacological interventions in cognitively impaired and demented patients a comparison with cholinesterase inhibiotrs", Reviews in the Neurosciences, 14, pp.343-368, 2003. DOI: http://doi.org/10.1515/revneuro.2003.14.4.343
  10. S. C. Burgener, L L. Buettner, E. Beattie, and L. Rose, "Effectiveness of community-based, nonpharmacological interventions for early-stage dementia: conclusions and recommendations", Journal of gerontological nursing, 35(3), pp.50-57, 2009. DOI: http://doi.org/10.3928/00989134-20090301-03
  11. N. H. Jung, "Randomized Controlled Trials on Community Based Occupational Therapy for the elderly with Dementia: Systematic Review", The Journal of Occupational Therapy for the Aged and Dementia, 13(1), pp.1-11, 2019. https://doi.org/10.34263/jsotad.2019.13.1.1
  12. J. H. Kong, S. Y. Yun and B. J. Choi, "The effects of reminiscence-based horticultural therapy on institutionalized demented elders' self-esteem and quality of life", Journal of Korean Society People Plants Environment, 18(4), pp.305-309, 2015. DOI: http://doi.org/10.11628/ksppe.2015.18.4.305
  13. K. A. Han and L. H. Moon, "A Meta-Analysis of the Effectiveness of Art Therapy for Elders with Dementia", Journal of Arts Psychotherapy, 15(3), pp.285-311, 2019. https://doi.org/10.32451/kjoaps.2019.15.3.285
  14. M. K. Lee and K. S. Kang, "The Effect of Music Therapy Using Songs and Mind Maps on Cognitive Function of the Elderly with Dementia in a Nursing Home", Journal of Arts Psychotherapy, 12(4), pp.25-47, 2016.
  15. H. L. Ro, K. C. Hwang and J. A. Kam, "Effects of Intentional Snoezelen Program on activiteis of daily living and Cognitive Functions of the Demented Elderly", Journal of Special Education & Rehabilitation Science, 50(3), pp.393-412, 2011.
  16. H. A. Park, "Evidence Base Medicine and Pre-Appraised Resources", Journal of the Korean Academy of Family Medicine, 31(12), pp.897-903, 2010. DOI: http://doi.org/10.4082/kjfm.2010.31.12.897
  17. L. Hedges, and I. Olkin, "Statistical methods for meta-analysis" Torontom ON: Academic Press Inc, 1985
  18. C. B. Kim. "Meta-Analysis, 2002 Lecture Book of the Korea Prevention Society", 1, pp.175-200, 2002.
  19. J. E. Suh and O. S. Cho, "The Impact of Physical Activity on Presbyophrenia Symptom: Meta Analysis", The Korea Journal of Sport, 13(4), pp.363-373, 2015.
  20. A. R. Jo and Y. S. Kim, "A Meta-analysis on the Effect of Music Therapy for Dementia", Korean Journal of Music Therapy, 17(2), pp.57-79, 2015. DOI: http://dx.doi.org/10.21330/kimt.2015.17.2.57
  21. K. S Kim and J. A. Lee, "Effects of Reminiscence Therapy on depressive Symptoms in Older Adults with Dementia: A Systematic Review and Meta-Analysis", Journal of Korean Academy of Nursing, 49(3), pp.225-240, 2019. DOI: http://doi.org/10.4040/jkan.2019.49.3.225
  22. S. Y. Hong and H. O. Park, "A Meta-analysis of the Risk Factors related to Falls among Elderly Patients with Dementia", Korean Journal of Adult Nursing, 29(1), pp.51-62, 2017. https://doi.org/10.7475/kjan.2017.29.1.51
  23. E. K., Kim and H. O. Park, "Factors associated with burden of family caregivers of home-dwelling elderly people with dementia: a systematic review and meta-analysis", Korean journal of Adult nursing, 31(4), pp.351-364, 2019. DOI: http://dx.doi.org/10.7475/kian.2019.31.4.351
  24. P. Y. Jeong, J. E. Sung, and H. S. Sim, " Meta-analysis of cognition-focused intervention for people with mild cognitive impairment and dementia", Communication Sciences & Disorders, 19(2), pp.199-212, 2014. DOI: http://dx.doi.org/10.12963/csd.14122
  25. M. H. Kwon and J. S. Lee, "The effect of nonpharmacologic interventions on behavioral and psychological symptoms of dementia: A meta-analysis", The Journal of the Korea Contents Association, 17(6), pp.540-550, 2017. DOI: http://dx.doi.org/10.5392/JKCA.2017.17.06.540
  26. H. J. Hong, "The Effects of Activity in Rhythem Movement on Depressive Mood, Behavioral and Psychological Symptoms in Elderly with Mild Alzheimer's Disease, Offical Journal of the Korean Society of Dance Science, 33(2), pp.97-110, 2016. DOI: http://dx.doi.org/10.23949/kjpe.2018.01.57.1.30
  27. M. Audiffren, "Acute exercise and psychological functions: a cognitive-energetic appproach" In T. McMorris, P. D. Tomporowski, & M. Audifferen(Eds.), 2009, pp.3-39. DOI: http://doi.org/10.1002/9780470740668.ch1
  28. S. Y. Kim, "Behavioral and Psychological Sympoms of Dementia", Dementia and Neurocognitive Disorders, 3(1), pp.14-17. 2004.
  29. T. Kurtoglu, I. Y. Tumer, D. C. Jensen, "A functional failure reasoning methodology for evaluation of conceptual system architecture", Research in Engineering Design, Vol.21, No.4, pp.209-234, Oct. 2010. DOI: https://doi.org/10.1007/s00163-010-0086-1