$\require{mediawiki-texvc}$

연합인증

연합인증 가입 기관의 연구자들은 소속기관의 인증정보(ID와 암호)를 이용해 다른 대학, 연구기관, 서비스 공급자의 다양한 온라인 자원과 연구 데이터를 이용할 수 있습니다.

이는 여행자가 자국에서 발행 받은 여권으로 세계 각국을 자유롭게 여행할 수 있는 것과 같습니다.

연합인증으로 이용이 가능한 서비스는 NTIS, DataON, Edison, Kafe, Webinar 등이 있습니다.

한번의 인증절차만으로 연합인증 가입 서비스에 추가 로그인 없이 이용이 가능합니다.

다만, 연합인증을 위해서는 최초 1회만 인증 절차가 필요합니다. (회원이 아닐 경우 회원 가입이 필요합니다.)

연합인증 절차는 다음과 같습니다.

최초이용시에는
ScienceON에 로그인 → 연합인증 서비스 접속 → 로그인 (본인 확인 또는 회원가입) → 서비스 이용

그 이후에는
ScienceON 로그인 → 연합인증 서비스 접속 → 서비스 이용

연합인증을 활용하시면 KISTI가 제공하는 다양한 서비스를 편리하게 이용하실 수 있습니다.

신경인지장애의 정신행동증상에 대한 비약물학적 개입
Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder 원문보기

精神身體醫學 = Korean journal of psychosomatic medicine, v.31 no.1, 2023년, pp.1 - 9  

김현 (인제대학교 의과대학 일산백병원 정신건강의학교실) ,  이강준 (인제대학교 의과대학 일산백병원 정신건강의학교실)

초록
AI-Helper 아이콘AI-Helper

신경인지장애 환자들은 인지저하 뿐만 아니라 초조, 공격성, 우울, 배회 등의 정신행동증상들을 나타내며 이로 인해 환자와 가족이 상당한 고통을 받게 된다. 정신행동증상의 치료를 위해서는 환자 중심의, 비약물학적인 치료가 우선되어야한다. 본 논문은 신경인지장애 환자에서 나타나는 정신행동증상을 관리하고 치료하기 위한 비약물학적인 개입에 대하여 기술하였다. 초조, 우울, 무감동, 불면, 배회 등의 정신행동증상을 조절하기 위해서는 환경변화, 약물 등의 유발 인자를 파악하고 평가한 뒤, 그러한 문제를 해결해주는 것이 중요하다. 비약물학적인 개입 방법으로는 안심시키기, 활동 격려하기, 주의를 분산시키기, 환경을 변화시키기 등을 들 수 있다. 환자의 관점에서 행동을 이해하고, 그들의 요구와 능력에 맞게 접근해야한다. 비약물학적인 개입 방법으로 회상요법, 음악치료, 향기요법, 다중감각자극요법, 운동요법, 광선치료, 마사지 요법, 인지중재치료, 애완동물요법 등의 다양한 요법이 시행되고 있으며, 이러한 접근 방법이 환자의 우울, 무감동, 초조, 공격성, 불안, 배회, 불면 등의 증상을 호전시켜준다고 알려져 있다. 그러나, 효과에 대한 증거 수준이 높지 않아 향후에 좀 더 광범위하고 정확한 효과 검증 연구가 필요하다.

Abstract ▼ AI-Helper 아이콘AI-Helper

Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-center...

주제어

#신경인지장애   #치매   #정신행동증상   #비약물학적 개입  

참고문헌 (76)

  1. Lanctot KL, Amarniek J, Ancoli-Israel S, Arnold SE, Ballard C, Cohen-Mansfield J, Ismail Z, Lyketsos C, Miller DS, Musiek E, Osorio RS, Rosenberg PB, Satlin A, Steffens D, Tariot P, Bain LJ, Carrillo MC, Hendrix JA, Jurgens H, Boot B. Neuropsychiatric signs and symptoms of Alzheimer's disease: new treatment paradigms. Alzheimers Dement (N Y) 2017;3:440-449.？ 

  2. Kameoka N, Sumitani S, Ohmori T. Behavioral and psychological symptoms of dementia (BPSD) and care burden: examination in the facility staff for elderly residents. J Med Invest 2020;67:236-239.？ 

  3. Edvarsson D, Winblad B, Sandman PO. Person-centered care of people with severe Alzheimer's disease: current status and ways forward. Lancet Neurol 2008;7:362-367.？ 

  4. Burley CV, Livingston G, Knapp MRJ, Wimo A, Norman R, Brodaty H. Time to invest in prevention and better care of behaviours and psychological symptoms associated with dementia. Int Psychogeriatr 2020;31:1-6.？ 

  5. Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ 2015;350:h369.？ 

  6. Zetteler J. Effectiveness of simulated presence therapy for individuals of dementia: a systematic review and meta-analysis. Aging Ment Health 2008;12:779-785.？ 

  7. Magierski R, Sobow T, Schwertner E, Religa D. Pharmacotherapy of behavioral and psychological symptoms of dementia: state of the art and future progress. Front Pharmacol 2020;11:1168.？ 

    상세보기

  8. Brasure M, Jutkowitz E, Fuchs E, Nelson VA, Kane RA, Shippee T. AHRQ comparative effectiveness reviews. Non-pharmacolgical interventions for agitation and aggression in dementia. Rockville (MD): Agency for Healthcare Research and Quality (US): 2016 Mar. Report No.:16-EHC019-EF.？ 

  9. Vandepitte S, Van Den Noortgate N, Putman K, Verhaeghe S, Faes K, Annemans L. Effectiveness of supporting informal caregivers of people with dementia: a systematic review of randomized and non-randomized controlled trials. J Alzheimers Dis 2016;52:929-965.？ 

  10. Leng M, Zhao Y, Wang Z. Comparative efficacy of nonpharmacological interventions on agitation in people with dementia: a systematic review and Bayesian network meta-analysis. Int J Nurs Stud 2020;102:103489.？ 

  11. Rodrigues S, Silva JMD, Oliveira MCC, Santana CME, Carvalho KM, Barbosa B. Physical exercise as a nonpharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials. Arq Neuropsiquaitr 2021;79:1129-1137.？ 

  12. Halpern R, Seare J, Tong J, Hartry A, Olaoye A, Aigbogun MS. Using electronic health records to estimate the prevalence of agitation in Alzheimer's disease/dementia. Int J Geriatr Psychiatry 2019;34:420-431.？ 

  13. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbaek G, Teri L, Mukadam N. Dementia prevention, intervention, and care. The Lancet Commissions 2017;390:2673-2734.？ 

  14. Z hao QF, Tan L, Wang HF, Jiang T, Tan MS, Tan L, Xu W, Li JQ, Wang J, Lai TJ, Yu JT. The prevalence of neuropsychiatric symptoms in Alzheimer's disease: systematic review and meta-analysis. J Affect Discord 2016;190:264-271.？ 

  15. Naasan G, Shdo SM, Rodriguez EM, Spina S, Grinberg L, Lopez I, Karydas A, Seeley WW, Miller BI, Rankin KP. Psychosis in neurodegenerative disease: differential patterns of hallucination and delusion symptoms. Brain 2021;144:999-1012.？ 

  16. Li G, Wang LY, Shofer JB, Thompson ML, Peskind ER, McCormick W, Bowen JD, Crane PK, Larson EB. Temporal relationship between depression and dementia: findings from a large community-based 15-year follow-up study. Arch Gen Psychiatry 2011;68:970-977.？ 

    상세보기

  17. Mirza SS, Wolters FJ, Swanson SA, Koudstaal PJ, Hofman A, Tiemeier H, Ikram MA. 10-year trajectories of depressive symptoms and risk of dementia: a population-based study. Lancet Psychiatry 2016;3:628-635.？ 

    상세보기

  18. Sepehry AA, Lee PE, Hsiung GY, Beattie BI, Jacova C. Effect of selective serotonin reuptake inhibitors in Alzheimer's disease with comorbid depression: a meta-analysis of depression and cognitive outcomes. Drugs Aging 2012;29:793-806.？ 

    상세보기

  19. Dudas R, Malouf R, McCleery J, Dening T. Antidepressants for treating depression in dementia. Cochrane Database Syst Rev 2018;8:CD003944.？ 

  20. de Vugt ME, Stevens F, Aalten P, Lousberg R, Jaspers N, Winkens I, Jolles J, Verhey FR. Behavioural disturbances in dementia patients and quality of the marital relationship. Int J Geriatr Psychiatry 2003;18:149-154.？ 

    상세보기

  21. Sepehry AA, Sarai M, Hsiung GR. Pharmacological therapy for apathy in Alzheimer's disease: a systematic review and meta-analysis. Can J Neurol Sci 2017;44:267-275.？ 

    상세보기

  22. Ruthirakuhan MT, Herrmann N, Abraham EH, Chan S, Lanctot KI. Pharmacological interventions for apathy in Alzheimer's disease. Cochrane database Syst Rev 2018;5:CD0121297.？ 

  23. Padala PR, Padala KP, Lensing SY, Ramirez D, Monga V, Bopp MM, Roberson PK, Dennis RA, Petty F, Sullivan DH, Burke WJ. Methylphenidate for apathy in community-dwelling older veterans with mild Alzheimer's disease: a double-blind, randomized, placebo-controlled trial. Am J Psycghiatry 2018;175:159-168.？ 

  24. McCurry SM, Gibbons LE, Logsdon RG, Vitiello MV, Teri L. Insomnia in caregivers of persons with dementia: who is at risk and what can be done about it? Sleep Med Clin 2009;4:519-526.？ 

  25. Jenny McCleery J, Sharpley AL. Pharmacotherapies for sleep disturbances in dementia. Cochrane Database Syst Rev 2020;15:CD009178.？ 

  26. Alzheimer's Association. Wandering and getting lost: Who's at risk and how to be prepared. Available from: https://www.alz.org/media/documents/alzheimers-dementia-wanderingbehavior-ts.pdf (2020; accessed July7, 2021).？ 

  27. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999;15:116-122.？ 

  28. Aud MA. Dangerous wandering: elopements of older adults with dementia from long-term care facilities. Am J Alzheimers Dis Other Demen 2004;19:361-368.？ 

  29. Sink KM, Covinsky KE, Newcomer R, and Yaffe K. Ethnic differences in the prevalence and pattern of dementia-related behaviors. J Am Geriatr Soc 2004;52:1277-1283.？ 

    상세보기

  30. Douglas A, Letts L, Richardson J. A systematic review of accidental injury from fire, wandering and medication self-administration errors for older adults with and without dementia. Arch Gerontol Geriatr 2011;52:e1-e10.？ 

    상세보기

  31. Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG; Old Age Task Force of the World Federation of Biological Psychiatry. Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry 2005;162:1996-2021.？ 

  32. Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012;169:946-953.？ 

  33. Testad I, Corbett A, Aarsland D, Lexow KO, Fossey J, Woods B, Ballard C. The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review. Int Psychogeriatr 2014;26:1083-1098.？ 

    상세보기

  34. Park K. A systematic review and meta-analysis on the effect of reminiscence therapy for people with dementia. Int Psychogeriatr 2019;31:1581-1597.？ 

    상세보기

  35. Subramaniam P, Woods B. The impact of individual reminiscence therapy for people with dementia: systematic review. Expert Rev Neurother 2012;12:545-555.？ 

  36. Garland K, Beer E, Eppingstall B, O'Connor DW. A comparison of two treatments of agitated behavior in nursing home residents with dementia: simulated family presence and preferred music, Am J Geriatr Psychiatry 2007;15:514-521.？ 

    상세보기

  37. Gerdner LA. An individualized music intervention for agitation. J Am Psychiatr Nurs Assoc 1997;3:177-184.？ 

  38. Gerdner LA. Effects of individualized vs classical relaxation music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders. Int Psychogeriatr 2000;12:49-65.？ 

  39. Sung HC, Lee WL, Li TL, Watson R. A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. Int J Geriatr Psychiatry 2012;27:621-627.？ 

    상세보기

  40. Svansdottir HB, Snaedal J. Music therapy in moderate and severe dementia of Alzheimer's type: a case-control study. Int Psychogeriatr 2006;18:613-621.？ 

    상세보기

  41. Holmes C, Knights A, Dean C, Hodkinson S, Hopkins V. Keep music live: music and the alleviation of apathy in dementia subjects. Int Psychogeriatr 2006;18:623-630.？ 

    상세보기

  42. Henry J, Rusius CW, Davies M. Lavender for night sedation of people with dementia. Int J Aromatherapy 1994;6:28-30.？ 

  43. Warren C, Warrenberg S. Mood benefits of fragrance. Int J Aromatherapy 1993;5:12-16.？ 

  44. Press-Sandler O, Freud, T, Volkov I, Peleg R, Press Y. Aromatherapy for the treatment of patients with behavioral and psychological symptoms of dementia: a descriptive analysis of RCTs. J Altern Complement Med 2016;22:422-428.？ 

    상세보기

  45. Lin PWK, Chan WC, Ng BFL, Lam LCW. Efficacy of aromatherapy(Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross-over randomized trial. Int J Geriatr Psychiatry 2007;22:405-410.？ 

    상세보기

  46. Burns A, Perry E, Holmes C. A double-blind placebo controlled randomized trial of Melissa officinalis oil and donepezil for the treatment of agitation in Alzheimer's disease. Dementi Geriatr Cogn Disord 2011;31:158-164.？ 

  47. Bpil S. Aromatherapy's effectiveness in disorders associated with dementia. Int J Aromatherapy 1993;5:20-23.？ 

  48. Wolfe N. Can aromathery oils promote sleep in severely demented patients? Int J Geriatr Psychiatry 1996;11:926-927.？ 

  49. Yang MH, Lin LC, Wu SC, Chiu JH, Wang PN, Lin JG. Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation. BMC Complement Altern Med 2015 Mar29;15:93.？ 

    상세보기

  50. Silva R, Abrunheiro S, Cardoso D, Costa P, Couto F, Agrenha C, Apostolo J. Effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder: asystemic review. JBI Database System Rey Implement Rep 2018;16:1663-1708.？ 

  51. Dowling Z, Baker R, Wareing LA. Lights, sound and special effects. J Dement Care 1997;Jan/Feb:16-18.？ 

  52. Baker R, Dowling Z, Wareing LA, Dawson J, Assey J. Snoezelen: Its long-term and short-term effects on older people with dementia. British J Occupational Ther 1997;60:213-218.？ 

  53. Moffat N, Barker P, Pinkney L, Garside M, Freeman C. Snoezelen: an experience for older people with dementia. Chesterfield: Rompa. 1993.？ 

  54. Baillon S, Van Diepen E, Prettyman R, Redman J, Rooke N, Campbell R. A comparison of the effects of Snoezelen therapy on the agitated behaviour of patients with dementia. Int J Geriatr Psychiatry 2004;19:1047-1052.？ 

  55. Staal JA, Sacks A, Matheis R, Collier L, Calia T, Hanif H, Kofman ES. The effects of snoezelen (multi-sensory behaviour therapy) and psychiatric care on agitation, apathy, and activities of daily living in dementia patients on a short-term geriatric psychiatric inpatient unit. Int J Psychiatry Med 2007;37:357-370.？ 

  56. Guzman-Garcia A, Hughes JC, James LA, Rochester L. Dancing as a psychosocial intervention in care homes: a systematic review of the literature. Int J Geriatr Psychiatry 2013;28:914-924.？ 

    상세보기

  57. Fleiner T, Leucht S, Forstl H, Zijstra W, Haussermann P. Effects of short-term exercise interventions on behavioral and psychological symptoms in patients with dementia: a systematic review. J Alzheimer's Dis 2017;55:1583-1594.？ 

  58. Brett L, Traynor V, Stapley P. Effects of physical exercise on health and well-being individuals living with a dementia in nursing homes: a systematic reviews. J Am Med Dir Assoc 2016;17:104-116.？ 

  59. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev 2015;4:Cd006489.？ 

  60. Behrman S, Chouliaras L, Ebmeier KP. Considering the senses in the diagnosis and management of dementia. Maturitas 2014;77:305-310.？ 

    상세보기

  61. Brasure M, Jutkowitz E, Fuchs E, Nelson VA, Kane RA, Shippee T, Kane RL. AHRQ comparative effectiveness reviews: nonpharmacologic interventions for agitation and aggression in dementia. Rockville, MD: Agency for Healthcare Research and Quality (US). 2016.？ 

  62. Burns A, Allen H, Tomenson B, Duignan D, Byrne J. Bright light therapy for agitation in dementia: a randomized controlled trial. Int Psychoger 2009;21:711-721.？ 

  63. Dowling GA, Graf CL, Hubbard EM, Luxenberg JS. Light treatment for neuropsychiatric behaviors in Alzheimer's disease. West J Nurs Res 2007;29:961-975.？ 

  64. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N. A systematic review of the clinical effectiveness and cost effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technol Assess 2014;18:1-226.？ 

  65. Scales K, Zimmerman S, Miller SJ. Evidence-based non-pharmacological practices to address behavioral and psychological symptoms of dementia. Gerontologist 2018;58(suppl_1):S88-S102.？ 

  66. Woods DL, Dimond M. The effect of therapeutic touch on agitated behavior and cortisol in persons with Alzheimer's disease. Biol Res Nurs 2002;4:104-114,？ 

  67. Legere LE, McNeill S, Schindel Martin L, Acorn M, An D. Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: a systematic review of reviews. J Clin Nurs 2018;27:e1360-e1376.？ 

  68. Sansone P, Schmitt L. Providing tender touch massage to el-dery nursing home residents: a demonstration project. Geriatr Nurs 2000;21:303-308.？ 

  69. Kilstoff K, Chenoweth L. New approaches to health and wellbeing for dementia day-care clients, family cares and day-care staff. Int J Nurs Pract 1998;4:70-83.？ 

  70. Remington R. Calming music and hand massage with agitated elderly. Nurs Res 2002;51:317-323.？ 

    상세보기

  71. Smallwood J, Brown R, Coulter F, Irvine E, Copland C. Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial. Int J Geriatr Psychiatry 2001;16:1010-1013.？ 

    상세보기

  72. Brunelle-Hamann L, Thivierge S, Simard M. Impact of a cognitive rehabilitation intervention on neuropsychiatric symptoms in mild to moderate Alzheimer's disease, Neuropsychol Reh 2015;25:677-707.？ 

  73. Folkerts AK, Roheger M, Franklin J, Middelstadt J, Kalbe E. Cognitive interventions in patients with dementia living in long-term care facilities: systematic review and meta-analysis. Arch Gerontol Geriatr 2017;73:204-221.？ 

    상세보기

  74. Churchill M, Safaoui J, McCabe BW, Baun M. Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer's disease. J Psychosoc Nurs Ment Health Serv 1999;37:16-22.？ 

    상세보기

  75. Hart LA. Psychosocial benefits of animal companionship. Handbook on animal-assisted therapy (Second Edition);2006. p.59-78.？ 

  76. Fritz CL, Farver TB, Kass PH, Hart LA. Association with companion animals and the expression of non-cognitive symptoms in Alzheimer's patients. J Nerv Ment Dis 1995;183:459-463. 

    상세보기

저자의 다른 논문 :

관련 콘텐츠

오픈액세스(OA) 유형

BRONZE

출판사/학술단체 등이 한시적으로 특별한 프로모션 또는 일정기간 경과 후 접근을 허용하여, 출판사/학술단체 등의 사이트에서 이용 가능한 논문

이 논문과 함께 이용한 콘텐츠

저작권 관리 안내
섹션별 컨텐츠 바로가기

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

AI-Helper 아이콘
AI-Helper
안녕하세요, AI-Helper입니다. 좌측 "선택된 텍스트"에서 텍스트를 선택하여 요약, 번역, 용어설명을 실행하세요.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.

선택된 텍스트

맨위로