Cognitive intervention using Montessori and DementiAbility for people with mild cognitive impairment

Chadchom Ratsameemonthon, Teppagone Pittayapinune, Arbtip Petchsakul, Sasithorn Kemsen
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Abstract

Background: Age-related illnesses are more prevalent with advancing age, with seniors facing more chronic diseases and disabilities. Chronic diseases that mostly older adults deal with are caused by high blood pressure, diabetes, and high cholesterol-also called noncommunicable diseases (NCDs). NCDs can cause severe chronic diseases such as heart disease, kidney failure, and cerebrovascular disease, and these can result in a high risk of Mild Cognitive Impairment (MCI). Together, brain cells shrink around 2,000 million cells when getting older, causing difficulty recalling names or words, decreased attention span, or a decreased ability to handle many tasks simultaneously. Therefore, protecting senior citizens with MCI needs to be seriously consideration. Objectives: This quasi-experimental research aimed to study the effects of a program to reduce brain deterioration in older people with Mild Cognitive Impairment (MCI). Materials and methods: The samples consisted of senior males and females requiring service at Songkhla Rajanagarindra Psychiatric Hospital, Songkhla, Thailand. A sample group was selected using an equivalent group design. The researcher utilized inclusion and exclusion criteria to gather 32 older adults and employed a simple random selection into experimental and control groups. For three months, the experimental group engaged in a seven-care-kit program based on Montessori’s philosophy and DementiAbility methods to help protect against brain deterioration. Mann-Whitney U test and Wilcoxon Value were used to analyze the result of the program’s effectiveness, which assessed cognitive ability by MoCA. Results: The attention span domain showed a significant statistical difference at (p=0.03) after post-tests comparing the experimental and control groups. A comparison of the pre-test and post-test of the experimental group found four domains-total cognitive domain, attention span domain, delayed recall domain, and visuospatial perception domain were significant with a statistical difference of (p=0.001, p=0.002, p=0.003, and p=0.004 respectively). Moreover, two domains- the delayed recall domain and the total cognitive domain in the control group showed a significant statistically increasing difference at (p=0.001 and p=0.005, respectively). Conclusion: The senior citizens’ active daily activities may help protect against dementia in older adults with MCI. The Home-Based Protection of Brain Deterioration Program demonstrated a satisfactory program that enhanced the attention span, visuospatial domain, and delayed recall of older people with mild cognitive impairment. Hence, the program as a dementia prevention program for older adults with MCI.
利用蒙特梭利和老年痴呆症辅助工具对轻度认知障碍患者进行认知干预
背景:随着年龄的增长,与年龄相关的疾病越来越普遍,老年人面临着更多的慢性疾病和残疾。大多数老年人要面对的慢性病是由高血压、糖尿病和高胆固醇引起的,也称为非传染性疾病(NCDs)。非传染性疾病可导致严重的慢性疾病,如心脏病、肾衰竭和脑血管疾病,这些疾病可导致轻度认知功能障碍(MCI)的高风险。随着年龄的增长,大脑细胞总共会萎缩约 20 亿个,从而导致记忆名字或单词困难、注意力下降或同时处理多项任务的能力下降。因此,保护患有 MCI 的老年人需要认真考虑。研究目的这项准实验研究旨在探讨一项旨在减少轻度认知障碍(MCI)老年人大脑退化的计划的效果。材料与方法:样本包括需要在泰国宋卡府宋卡拉拉贾那加林德拉精神病医院接受服务的老年男性和女性。样本组的选择采用等效组设计。研究人员利用纳入和排除标准收集了 32 名老年人,并采用简单随机的方式将其分为实验组和对照组。在为期三个月的时间里,实验组参与了基于蒙特梭利理念和老年痴呆症防治方法的七项护理套件计划,以帮助保护老年人的大脑,防止其功能退化。实验组采用 Mann-Whitney U 检验和 Wilcoxon 值来分析该计划的效果,该计划通过 MoCA 评估认知能力。结果显示实验组和对照组在后测之后的注意广度领域有明显的统计学差异(P=0.03)。对比实验组的前测和后测发现,四个领域--总认知领域、注意力领域、延迟回忆领域和视觉空间感知领域--都有显著的统计学差异,分别为(P=0.001、P=0.002、P=0.003 和 P=0.004)。此外,对照组的两个领域--延迟回忆领域和总认知领域--在统计学上有显著的增加差异(分别为 p=0.001 和 p=0.005)。结论老年人积极参加日常活动有助于预防患有 MCI 的老年人患痴呆症。以家庭为基础的脑退化保护计划在提高轻度认知障碍老年人的注意广度、视觉空间领域和延迟记忆方面的效果令人满意。因此,该计划可作为患有 MCI 的老年人的痴呆症预防计划。
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