多组分运动联合认知训练在老年精神障碍合并肌少症患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.03.002

摘要/Abstract

摘要：

目的探究多组分运动联合认知训练对老年精神障碍合并肌少症患者的影响，为降低其跌倒风险、预防和改善肌少症、提高认知功能提供参考。方法采用文献分析和专家会议法构建多组分运动联合认知训练方案。采用类实验研究设计，便利选取2023年1月—2024年2月在上海市某精神卫生中心住院的76例老年精神障碍合并肌少症患者为研究对象，按住院楼号分为试验组和对照组（各38例），试验组在常规护理的基础上接受多组分运动联合认知训练，对照组接受常规护理。干预12周后，比较两组跌倒风险、骨骼肌质量、肌肉力量、躯体功能、认知功能和不良事件的发生情况。结果共有75例患者完成研究，试验组38例，对照组37例。干预后试验组起立-行走计时测试时间、6 m步速、简易躯体功能状态评估量表得分均优于对照组（P<0.05），骨骼肌质量、肌肉力量、小腿围、躯体功能、认知功能评分均高于对照组（P<0.05），两组均未发生不良事件。结论多组分运动联合认知训练能有效降低老年精神障碍合并肌少症患者的跌倒风险，增强其骨骼肌质量、肌肉力量和躯体功能，改善其认知功能。

关键词: 老年人, 精神障碍, 肌少症, 跌倒, 多组分运动, 认知训练, 护理

Abstract:

Objective To explore the effect of a multicomponent exercise and cognitive stimulation program in elderly patients with mental disorders and sarcopenia，so as to provide references for reducing the risk of falls，preventing and improving sarcopenia，and enhancing cognitive function in patients. Methods The multi-component exercise and cognitive stimulation program was formulated through literature review and expert meeting. In this quasi-experimental study，76 elderly patients with mental disorders and sarcopenia who were hospitalized in a tertiary mental health center in Shanghai from January 2023 to February 2024 were selected as research subjects. They were randomly divided into an experimental group and a control group according to their hospitalization building number（38 cases in each group）. The experimental group was treated with multicomponent exercise combined with cognitive stimulation program based on routine nursing，and the control group was treated with routine nursing. The risk of falls，skeletal muscle mass，muscle strength，physical function，cognitive function，and incidence of adverse events were compared between 2 groups after 12 weeks of intervention. Results A total of 75 patients with 37 in the control group and 38 in the experimental group completed the study. The TUG time，6M walking speed and the score of Short Physical Performance Bettery of the experimental group were all lower than those of the control group（P<0.05），and the scores of skeletal muscle mass，muscle strength，calf circumference，physical function and cognitive function of the experimental group were all higher than those of the control group（P<0.05）. Neither group experienced any adverse events. Conclusion The application of this multicomponent exercise combined cognitive stimulation program developed for elderly patients with mental disorders and sarcopenia can effectively reduce the risk of falls，enhance the skeletal muscle mass and muscle strength and improve the cognitive function in elderly patients with mental disorders and sarcopenia.

Key words: Aged, Mental Disorders, Sarcopenia, Falls, Multicomponent Exercise, Cognitive Stimulation, Nursing Care

金晓超, 施忠英, 周英凤, 黄晓燕, 黄楚贤, 顾艳虹, 苏雅, 李丽. 多组分运动联合认知训练在老年精神障碍合并肌少症患者中的应用研究[J]. 中华护理杂志, 2025, 60(3): 266-273.

JIN Xiaochao, SHI Zhongying, ZHOU Yingfeng, HUANG Xiaoyan, HUANG Chuxian, GU Yanhong, SU Ya, LI Li. Application of a multicomponent exercise and cognitive stimulation program in elderly patients with mental disorders and sarcopenia[J]. Chinese Journal of Nursing, 2025, 60(3): 266-273.

图/表 4

表1 两组一般资料的比较

Table 1 Comparison of general data between the 2 groups

表2 两组起立-坐起计时测试的比较（s，$\bar{x}±s$）

Table 2 Comparison of TUG between the 2 groups（s，$\bar{x}±s$）

表3 两组干预前后肌少症相关指标的比较

Table 3 Comparison of related indexes of sarcopenia between the 2 groups

表4 两组干预前后认知功能的比较[分，M（P25，P75）]

Table 4 Comparison of cognitive function between the 2 groups[scores，M（P25，P75）]

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