2014-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/655236摘要：認知衰退會對老人及其家庭產生負面影響，進而造成健康照護系統在財政上的負擔。近幾十年，國外不斷地發展改善老人認知功能的介入試驗，而根據相關研究的統合分析證實：『身體活動』與『認知參與』為有效降低罹患失智症和認知衰退風險的重要因子；反觀國內，有關此部分的介入研究卻非常缺乏，故發展本土化介入措施有其必要性。本研究採重複測量的實驗設計，包含四組實驗組及一組控制組，目的在探討身體活動及/或認知訓練對機構老年住民認知功能的成效。研究場所為臺北市、新北市願意參與研究之立案安養護機構，採用機構群聚指派(cluster assignment)方式，將同一機構內符合收案條件且願意參與研究的所有個案皆被分配至同一介入措施。本研究將分二階段共計三年進行，第一階段為期二年，主要執行三組實驗組：高強度認知訓練(5 天/週)、身體活動(5 天/週)、低強度整合性介入(2 天認知訓練+3 天身體活動/週)並完成三者之劑量-配對(dose-matched)成效比較；第二階段為期一年，主要執行一組高強度整合性介入(5 天認知訓練+5 天身體活動/週)並與第一階段結果比較，探討四種不同介入措施之劑量-反應、成效比對與影響因素探討。四組實驗組個案在研究階段將接受為期8 週，每週5 天，每種介入30 分鐘的設計。所有個案將分別於介入措施開始前1-2 天(T0)、介入結束後1-2天(T1)、以及介入結束後8 週(T2)等3 個時間點，進行實驗組、控制組之認知功能、憂鬱與生活品質等成效指標資料收集，預計每組收案45 名老年住民，五組共225 名個案資料。所得資料將以統計軟體SPSS 16.0 進行描述性分析、卡方檢定、單因子變異數、相關分析、重複測量方差等分析，研究結果將可增加這些介入處置成效的實證基礎。<br> Abstract: Cognition decline often has a negative impact on elderly and family and furtherplace a financial burden on healthcare systems. There were more clinical trials inelderly for improving cognitive function in recent decades. A recent meta-analysisshowed that a fairly consistent association with decreased risk of Alzheimer's diseaseand cognitive decline were: cognitive engagement and physical activities. However,validation of the efficacy of various interventions improving cognitive function islacking in Taiwan. To develop localized interventions adapted for Taiwanese’s contextare necessary.This is a 3-year research proposal that is aimed at improving the cognitivefunction of institutionalized older residents by physical activity and cognitive training.A repeated measures experimental design, which including four experimental groupsand one control group, is used. Elder adults are chosen from institutions in Taipei andnew Taipei city and allocated to intervention or control groups by institution clusterassignment. This study will be divided into two stages for three years. In stage one,we develop three 8-weeks dose-matched different interventions (physical activity,cognitive training, low intensity intervention integrated of physical activity andcognitive training in order to examine the impacts of three different intervention onoutcome indicators and various cognitive-domains. In stage two, an 8-weeks highintensity intervention intergrated of physical activity and cognitive training was usedto explore the effect on outcome indicators in institutionalized older residents.Furthermore, we will analyze the effects of the various interventions and compare ofdose-response relation and efficacy, and try to identify possible influencing factors.The intervention group receives 30-minute physical activity, or cognitive training, orits combination five times per week for 8 weeks. Measure of outcome indicators,cognitive function, depression and quality of life, are taken at 0 week (pre-treatment),8 weeks (post-treatment) and 16 weeks (follow-up). The anticipated sample size is 45for each group. A total of 225 of institutionalized elderly residents will be recruited.The statistical analysis will be conducted utilizing the statistical software SPSS 16.0version. Descriptive analysis, chi-square, one-wayANOVA, two-factors repeatedmeasure ANOVA, and multivariate-MANOVA, GEE model, Pearson correlation andmultiple regression will be used to analyze the data. The results of the study will addto the growing evidence base on the effect of these interventions.身體活動認知訓練整合性介入措施認知功能憂鬱程度生活品 質physical activitycognitive trainingintegrated training programcognitive functiondepressionquality of life