medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-044medsovet-8182Research ArticleКОГНИТИВНЫЕ РАССТРОЙСТВАCOGNITIVE DISRODERSРезультаты открытого одноцентрового клинического исследования по оценке эффективности и безопасности групповой когнитивной стимулирующей терапии у русскоговорящих пациентов с болезнью Альцгеймера на стадии умеренной деменцииResults from the open-label, single-center, clinical study assessing the efficacy and safety of a group cognitive stimulation therapy in Russian-speaking patients with the moderate dementia stage of Alzheimer's diseasehttps://orcid.org/0000-0002-9851-4362ЖитковаЮ. В.ZhitkovaY. V.

Житкова Юлия Владимировна, д.м.н., врач-невролог, главный внештатный специалист по неврологии Управления здравоохранения по г. Казани, руководитель; ассистент Института дополнительного образования,

420101, Республика Татарстан, Казань, ул. Карбышева, д. 12а

420012, Республика Татарстан, Казань, ул. Бутлерова, д. 49

Yulia V. Zhitkova, Dr. Sci. (Med.), Neurologist, Chief freelance Neurology Specialist of the Kazan Health Department, Head of the Republican Center for Cognitive Disorders; Assistant at the Institute of Additional Education

12а, Karbishev St., Kazan, Republic of Tatarstan, 420101

49, Butlerov St., Kazan, Republic of Tatarstan, 420012

zhitkova@mail.ruhttps://orcid.org/0009-0007-8008-672XГаспарянГ. А.GasparianA. A.

Гаспарян Армине Агвановна, врач-невролог

420101, Республика Татарстан, Казань, ул.  Карбышева, д.  12а

Armine А. Gasparian, Neurologist, Republican Center for Cognitive Disorders

12а, Karbishev St., Kazan, Republic of Tatarstan, 420101

armineg@mail.ruhttps://orcid.org/0009-0003-0346-9568СарвароваА. Ф.SarvarovaA. F.

Сарварова Аделя Фарисовна, студент лечебного факультета

420012, Республика Татарстан, Казань, ул. Бутлерова, д. 49

Adelya F. Sarvarova, Student of the Faculty of Medicine

49, Butlerov St., Kazan, Republic of Tatarstan, 420012

adelya.sarvarova22@yandex.ruhttps://orcid.org/0009-0006-4735-3788КоробоваД. А.KorobovaD. A.

Коробова Дарья Андреевна, студент лечебного факультета

420012, Республика Татарстан, Казань, ул. Бутлерова, д. 49

Daria А. Korobova, Student of the Faculty of Medicine

49, Butlerov St., Kazan, Republic of Tatarstan, 420012

dar.korobova@gmail.comhttps://orcid.org/0009-0008-8716-5049ГалявоваФ. И.GalyavovaF. I.

Галявова Фирюза Исмагиловна, студент педиатрического факультета

420012, Республика Татарстан, Казань, ул. Бутлерова, д. 49

Firyuza I. Galyavova, Student of the Pediatric Faculty

49, Butlerov St., Kazan, Republic of Tatarstan, 420012

f-ganeeva@mail.ruhttps://orcid.org/0009-0008-9214-1885БайназароваА. И.BaynazarovaA. I.

Байназарова Алия Ильгизовна, психолог, президент

420049, Республика Татарстан, Казань, ул. Нурсултана Назарбаева, д. 8а

Aliya I. Baynazarova, Psychologist, President

8а, Nursultan Nazarbayev St., Kazan, Republic of Tatarstan, 420049

fund.blagie.dela@gmail.comhttps://orcid.org/0009-0006-6866-9546ХамидуллинаА. М.KhamidullinaA. M.

Хамидуллина Алия Маратовна, руководитель программ и специалист социальной работы

420049, Республика Татарстан, Казань, ул. Нурсултана Назарбаева, д. 8а

Aliya М. Khamidullina, Program Manager and Social Work Specialist

8а, Nursultan Nazarbayev St., Kazan, Republic of Tatarstan, 420049

fund.blagie.dela@gmail.comhttps://orcid.org/0009-0005-6958-1100ДоманскаяЕ. В.DomanskayaE. V.

Доманская Елена Владимировна, психолог, директор

420141, Республика Татарстан, Казань, ул. Юлиуса Фучика, д. 82

Elena V. Domanskaya, Psychologist, Director

82, Julius Fuchik St., Kazan, Republic of Tatarstan, 420141

Avroraross@bk.ruРеспубликанский центр когнитивных расстройств, Межрегиональный клинико-диагностический центр; Казанский государственный медицинский университетРоссияInterregional Clinical and Diagnostic Center; Kazan State Medical UniversityRussian FederationРеспубликанский центр когнитивных расстройств, Межрегиональный клинико-диагностический центрРоссияInterregional Clinical and Diagnostic CenterRussian FederationКазанский государственный медицинский университетРоссияKazan State Medical UniversityRussian FederationБлаготворительный фонд «Благие дела»РоссияCharitable Foundation “Good Deeds”Russian FederationЦентр социальной заботы «Зилант»РоссияZilant Social Care CenterRussian Federation202401052024034350Copyright © Житкова Ю.В., Гаспарян Г.А., Сарварова А.Ф., Коробова Д.А., Галявова Ф.И., Байназарова А.И., Хамидуллина А.М., Доманская Е.В., 20242024Житкова Ю.В., Гаспарян Г.А., Сарварова А.Ф., Коробова Д.А., Галявова Ф.И., Байназарова А.И., Хамидуллина А.М., Доманская Е.В.Zhitkova Y.V., Gasparian A.A., Sarvarova A.F., Korobova D.A., Galyavova F.I., Baynazarova A.I., Khamidullina A.M., Domanskaya E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8182Введение

Введение. Метод когнитивной стимулирующей терапии (КСТ) применяется в мире для лечения когнитивных нарушений и в последние годы вызывает интерес в России. Однако существует потребность в адаптации КСТ для русскоговорящих пациентов с деменцией. 

Цель

Цель. Оценить эффективность и безопасность русскоязычной версии КСТ у русскоговорящих пациентов с болезнью Альцгеймера на стадии умеренной деменции.

Материалы и  методы

Материалы и  методы. В  исследование включены 8  пациентов с  установленным диагнозом деменции при болезни Альцгеймера, проживающих в центре социальной заботы «Зилант». Средний возраст участников 76 ± 10,8 года. Значение по шкале MMSE на скрининге составило 17 ± 5,0 балла. Проведен основной курс КСТ по методике, разработанной Э. Спектор и соавт., переведенной и культурно адаптированной нами на русский язык. Динамически оценивалось состояние когнитивных функций, когнитивное функционирование, психическая симптоматика, а также удовольствие и вовлеченность пациентов в процесс занятий. Исследование завершили 7 пациентов: один был исключен по причине неусидчивости и беспокойства.

Результаты

Результаты. К концу лечения установлено улучшение когнитивных функций (р = 0,002 по шкале ADAS-Cog по сравнению с исходным уровнем). По шкале NPI установлена редукция симптомов бреда и апатии с соответствующим снижением дистресса ухаживающих, что способствовало уменьшению дозировок антипсихотиков. По шкалам Lowton & Brody и ADCS-ADL установлено улучшение когнитивного функционирования. Наиболее ярким показателем эффективности КСТ явилось повышение настроения и удовлетворенности пациентов, что более значимо в повседневной жизни и может считаться показателем безопасности КСТ.

Выводы

Выводы. Русскоязычная версия КСТ была эффективна и безопасна у пациентов с болезнью Альцгеймера на стадии умеренной деменции и может быть рекомендована для внедрения в клиническую практику. Это открывает перспективы для изучения КСТ в комплексном лечении деменций различного генеза.

Introduction

Introduction. Cognitive stimulation therapy (CST) used worldwide to treat cognitive impairment has recently attracted interest of Russian medical and scientific minds. However, when applied to Russian-speaking patients with dementia, CST requires adaptation. Aim. To evaluate the effectiveness and safety of the Russian-language version of CST for Russian-speaking patients with Alzheimer’s disease at the stage of moderate dementia.

Materials and мethods

Materials and мethods. 8 participants involved into the trial were residents of social care center ZILANT diagnosed as dementia patients with Alzheimer’s, aged 76 ± 10.8 years, with the median MMSE score identified 17 ± 5.0. Before implementing the main course of CST developed by E. Spector et al we translated and localized it for Russian patients. The patients undergoing CST were assessed for the state of cognitive functions, everyday activity, mental symptoms, as well as enjoyment and involvement. One of the recruited patients was excluded due to restlessness and anxiety.

Results

Results. Seven patients had significantly improved on ADAS-Cog scale (p = 0.002), Lowton&Brody and ADCS-ADL. The NPI scale indicated a reduction in symptoms of delirium and apathy which contributed to a reduction in antipsychotic dosages and a corresponding decrease in caregiver’s distress. The most striking indicator of CST effectiveness was improvements in the patient’s mood and satisfaction, which we view significant in everyday life and as an indicator of CST safety.

Conclusion

Conclusion. The Russian-language version of CST proved effective and safe for moderate dementia patients with Alzheimer’s and can be recommended for implementing in clinical practice. This opens up prospects for studying CST as part of various drug strategies in treatment of dementia of various origins.

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The authors declare that there are no conflicts of interest present.