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認知症 (preDIVA) を予防するための6年間の多領域血管ケア介入の有効性:クラスターランダム化制御試験
Eric P Moll van Charante1, Edo Richard2, Lisa S Eurelings3
1Department of General Practice, Academic Medical Centre, Amsterdam, Netherlands.
Lancet (London, England)
|July 31, 2016
まとめ
医療従事者の指導による心臓血管リスク要因を標的とした介入は,高齢者の認知症を予防できなかった. 選択された集団でさらなる研究が必要である.
科学分野:
- ゲロントロジー
- 神経学
- 心臓病科
背景:
- 心血管疾患の危険因子は認知症のリスクの増加と関連しています.
- 認知症の予防に多分野介入の影響を評価することは 老化人口にとって極めて重要です
研究 の 目的:
- 医療従事者の指導による多領域の介入で 心血管疾患のリスク要因を標的として コミュニティに住む高齢者の認知症を予防できるかどうかを評価する.
主な方法:
- 70~78歳の個人を対象とした6年間のクラスターランダム化制御試験です.
- 介入グループは看護師の指導によるケアを受け,対照群は通常のケアを受けていました.
- 主要アウトカムには認知症の発生率と障害のスコアが含まれ,次要アウトカムは心血管疾患と死亡率でした.
主要な成果:
- 介入群 (7%) と対照群 (7%) の間で認知症の発生率に有意な差はない (HR 0. 92, 95% CI 0. 71-1.19).
- 障害のスコア,心血管疾患の発生率,または死亡率において,グループ間の有意な差異は観察されなかった.
- 主要または次要のアウトカムには統計的に有意な影響はなかった.
結論:
- 看護師主導の多領域介入は,未選択の高齢者集団における全因性認知症の発生率を減少させなかった.
- 効果の欠如の潜在的な理由には,初期的な心血管リスクと高い標準の通常のケアが含まれます.
- 将来の研究は,特定の選択された集団におけるそのような介入の有効性に焦点を当てなければならない.
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