Wirksamkeit von Interventionen zur Stärkung kognitiver Ressourcen bei Bewohnenden in Pflegeheimen

Eine systematische Übersichtsarbeit und Netzwerkmetaanalyse

Effectiveness of interventions to strengthen cognitive resources in nursing home residents

A systematic review and network meta-analysis

Zusammenfassung

Hintergrund

Die Stärkung kognitiver Ressourcen von Bewohnenden im Setting stationärer Pflege ist ein wichtiges Ziel präventiver Aktivitäten. Zielsetzung dieser systematischen Übersichtsarbeit ist die Beantwortung der Frage, welche Intervention bei stationär Pflegebedürftigen am wirksamsten ist, um ihre kognitiven Ressourcen zu stärken.

Methodik

Die systematische Literaturrecherche erfolgte in der Cochrane Library und den Datenbanken MEDLINE (PubMed), Embase, CINAHL, PsycINFO und PEDro. Es wurden Referenzverzeichnisse der als relevant eingestuften Veröffentlichungen durchgesehen und Studienregister durchsucht. Die Literaturselektion, Datenextraktion und Einschätzung der Studienqualität wurden im Vier-Augen-Prinzip vorgenommen. Eine frequentistische Netzwerkmetaanalyse mit zufälligen Effekten wurde durchgeführt.

Ergebnisse

Es wurden 29 Studien mit 1816 Teilnehmenden eingeschlossen. Sowohl körperliche Aktivität (Standardisierte Mittelwertdifferenz [SMD] = 0,70, 95 %-Konfidenzintervall [KI] 0,35–1,06, p < 0,001) als auch kognitive Aktivität (SMD = 0,61, 95 %-KI 0,22–1,01, p < 0,01) waren der üblichen Versorgung statistisch signifikant hinsichtlich der Stärkung kognitiver Ressourcen überlegen. Die Effekte von körperlicher und kognitiver Aktivität auf die kognitiven Ressourcen unterschieden sich statistisch nichtsignifikant voneinander. Zudem zeigten weder körperliche noch kognitive Aktivität im Vergleich mit sozialen Aktivitäten statistisch signifikant bessere kognitive Ressourcen bei stationär Pflegebedürftigen.

Schlussfolgerung

Es gibt Hinweise, dass die kognitiven Ressourcen von Bewohnenden im Setting stationärer Pflege sowohl durch körperliche Aktivität als auch kognitive Aktivität gestärkt werden können. Aufgrund einer insgesamt niedrigen Evidenzgüte sind qualitativ hochwertige Studien für die Überprüfung der Robustheit der statistischen Ergebnisse notwendig.

Abstract

Background

Strengthening cognitive resources of residents in nursing homes is an important goal of preventive activities. The aim of this systematic review was to answer the question which intervention is most effective for nursing home residents to strengthen their cognitive resources.

Method

A systematic literature search was carried out in the Cochrane Library and the MEDLINE (PubMed), Embase, CINAHL, PsycINFO and PEDro databases. Reference lists of publications classified as relevant were checked and trial registries were searched. The literature selection, data extraction and assessment of the study quality were carried out by two reviewers independently. A frequentist network meta-analysis was conducted using a random effects model.

Results

A total of 29 studies with 1816 participants were included. Both physical activity (standardized mean difference [SMD] = 0.70, 95%-confidence interval [CI] 0.35–1.06, p < 0.001) and cognitive activity (SMD = 0.61, 95%-CI 0.22–1.01, p < 0.01) were statistically significantly superior in strengthening cognitive resources compared to usual care. Physical and cognitive activities did not differ statistically significantly from each other. In addition, neither physical activity nor cognitive activity showed statistically significantly better cognitive resources in nursing home residents compared to social activities.

Conclusion

The findings imply that physical activity as well as cognitive activity could be effective to strengthen cognitive resources of nursing home residents. Considering the low-quality of available evidence, performance of high-quality studies is essential in order to verify the robustness of the statistical results.

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Correspondence to C. Wöhl.

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C. Wöhl, H. Siebert und B. Blättner geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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CRD42018092985

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Wöhl, C., Siebert, H. & Blättner, B. Wirksamkeit von Interventionen zur Stärkung kognitiver Ressourcen bei Bewohnenden in Pflegeheimen. Z Gerontol Geriat 53, 778–787 (2020). https://doi.org/10.1007/s00391-019-01654-9

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Schlüsselwörter

  • Körperliche Aktivität
  • Kognitive Aktivität
  • Kognitive Leistungsfähigkeit
  • Stationäre Pflege
  • Netzwerkmetaanalyse

Keywords

  • Motor activity
  • Cognitive activity
  • Cognitive performance
  • Nursing homes
  • Network meta-analysis