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摘要
痴呆的行为和精神症状(BPSD),也被称为精神病或非认知性症状是常见的老年痴呆症常见和多发的令人苦恼的特征。BPSD显著增加病人的痛苦、早期的制度化管理与照顾者的负担。BPSD的临床治疗是通过药理学方法为主,而这些药物往往伴有严重的副作用。仅有少数对BPSD的非药物治疗策略。大量的对BPSD的非药物治疗方案的干预研究,主要关注于体育锻炼。虽然这些研究在老年痴呆症的类型和严重程度方面以及运动干预的类型和持续时间有很大的差异性,整体上显示体育锻炼能减轻BPSD的积极作用。有许多证据表明体育锻炼对BPSD的积极作用的机制。到目前为止,没有试图综述现有的已知的机制知识。因此,此综述的目的是整合现有的锻炼身体的有益效果有助于改善阿尔茨海默病性痴呆的BPSD在心理和神经生物学机制的证据。讨论包括运动诱导的神经递质浓度变化、神经营养因子和免疫活化合成的增加的神经生物学机制,接着讨论改善睡眠和减轻压力的心理机制。最后建议未来的研究应克服研究现状的不足,拓展现有的体育锻炼对BPSD的积极影响的知识。
关键词: 阿尔茨海默氏痴呆,BPSD,体育锻炼、神经精神症状、神经生物学机制、心理机制。
Current Alzheimer Research
Title:Physical Exercise for the Treatment of Neuropsychiatric Disturbances in Alzheimer’s Dementia: Possible Mechanisms, Current Evidence and Future Directions
Volume: 13 Issue: 10
Author(s): Silke Matura, André F. Carvalho, Gilberto S. Alves, Johannes Pantel
Affiliation:
关键词: 阿尔茨海默氏痴呆,BPSD,体育锻炼、神经精神症状、神经生物学机制、心理机制。
摘要: Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric or non-cognitive symptoms are common and often distressing features of Alzheimer's Dementia. BPSD significantly increase patient suffering, early institutionalization and caregiver's burden. The clinical management of BPSD is dominated by a pharmacological approach, although these medications often come with serious adverse side-effects. There are only few nonpharmacological treatment strategies for BPSD. A substantial amount of intervention studies that have investigated non-pharmacological treatment options for BPSD have focused on physical exercise. Although these studies are very heterogeneous in terms of type and severity of dementia, as well as type and duration of the exercise intervention, the overall picture shows a positive effect of physical exercise in alleviating BPSD. There is evidence that numerous mechanisms contribute to the positive effect of physical exercise on BPSD. No attempt has been undertaken so far to give an overview of the existing knowledge regarding these mechanisms. Therefore, the current review aims to integrate the existing evidence on psychological and neurobiological mechanisms that contribute to the beneficial effects of physical exercise in ameliorating BPSD in Alzheimer's dementia. A discussion of psychological mechanisms such as improved sleep and stress reduction will be followed by a discussion of neurobiological mechanisms including the exercise induced change in neurotransmitter concentrations, increased synthesis of neurotrophins and immune activation. The review closes with recommendations for future research to overcome the shortcomings of existing studies and broaden the current knowledge on the positive effects of physical exercise on BPSD.
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Silke Matura, André F. Carvalho, Gilberto S. Alves, Johannes Pantel , Physical Exercise for the Treatment of Neuropsychiatric Disturbances in Alzheimer’s Dementia: Possible Mechanisms, Current Evidence and Future Directions, Current Alzheimer Research 2016; 13 (10) . https://dx.doi.org/10.2174/1567205013666160502123428
DOI https://dx.doi.org/10.2174/1567205013666160502123428 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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