About this trial
The incidence of MBI and the probability of progression to dementia are high. Early detection and intervention have important clinical significance to reduce the occurrence of dementia, delay the progression of dementia and promote healthy aging to active aging. The occurrence and development of NPS in MBI patients may be related to genetic and degenerative changes in the central nervous system. The evaluation of MBI patients is mainly based on neuropsychological tests, including NPS and cognitive function assessment. Landmark model is an effective tool for dynamic risk prediction of the progress of MBI. It can make dynamic prediction at different time points according to various existing measurement indicators of an individual and calculate the individual prediction probability, which is one of the best models for studying the outcome of disease at present. The Landmark model is applied to the elderly MBI population to study the influencing factors of normal aging, MBI and dementia and the probability of metastasis, which is a beneficial attempt to further advance the defense line of dementia. Personalized non-drug intervention is the preferred treatment for MBI, which mainly includes cognitive/emotional intervention, sensory stimulation, exercise therapy, etc. Currently, it is recommended to adopt diversified strategies to implement individualized precision treatment programs for patients. The hierarchical and classified health management of elderly MBI patients combined with health portrait technology is helpful to improve management efficiency and better meet the needs of personalized health management for the elderly.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Meet the ISTAART diagnostic criteria for MBI;
Age ≥60 years old;
No obvious visual or hearing impairment;
Have the ability of language communication, can complete the scale assessment.
Disqualifiers
Patients with severe physical diseases and unable to complete cognitive function screening;
Patients with other neurological diseases and serious medical diseases that can cause brain dysfunction.
Trial design
Parallel
Treatments tested in this trial
Personalized intervention
Other interventionPersonalized intervention means implementing multi-component non-pharmacological interventions based on different health profiles,such as art therapy, exercise therapy, cognitive therapy and other monotherapies. Usual care means care as routine.
Treatment groups
Trial outcomes
Primary outcomes
General cognitive function
The Montreal Cognitive Assessment Scale, developed by Nasreddine in 2004 to assess participants' general cognitive function, covers eight areas of cognitive assessment, including visuospatial and executive function, naming, memory, attention, speech, abstraction, delayed recall, and orientation. The Changsha version of the Montreal Cognitive Assessment Scale was used in this study, and its Cronbach's α coefficient was 0.846, retest reliability was 0.974, and investigator reliability was 0.969. The score of the Montreal Cognitive Assessment Scale ranges from 0 to 30 points. The higher the score, the better the cognitive function of the study subjects. The illiterate group ≤13, the primary school group ≤19, and the junior high school and above group ≤24 can be judged as impaired cognitive function to correct the bias caused by education level
Secondary outcomes
Sleep condition
The Pittsburgh Sleep Quality Index, developed by Buysse equals in 1989, was used to evaluate the sleep status of the participants over the past month. The Pittsburgh Sleep Quality Index includes seven components: subjective sleep quality, sleep duration, sleep duration, sleep efficiency, sleep disorders, hypnotic drugs, and daytime function, with good internal consistency (Cronbach's α=0.83) and retest reliability (r=0.85). The cumulative score for each component of the Pittsburgh Sleep Quality Index Scale is the total score of the scale, ranging from 0 to 21, with a score of 0 to 3 for each component, with higher scores associated with poorer sleep quality
Social participation
The Social Support Rating Scale was used to assess participants' social participation. This study adopted the social support assessment compiled by domestic scholar Xiao Shuiyuan, which has good reliability and validity (Cronbach's α coefficient is 0.83). There are 10 items in the social support evaluation, including objective support, subjective support and social support utilization. The score ranges from 11 to 40 points. The higher the score of each dimension, the higher the degree of social support. It is generally believed that the total score of 20 is poor social support, 20-30 is general social support, and 30-40 is satisfactory social support
Dementia conversion rate
The Condensed Mental State Scale, developed by Folstein et al., is increasingly being used to screen patients for dementia, determine the severity of cognitive impairment, and determine dementia transition. The sensitivity and specificity of the concise mental State scale in the screening diagnosis of dementia are 80-90% and 70-80%. The scale covers cognitive areas such as orientation, memory, attention and computation, speech and visuospatial. The Condensed Mental State Scale ranges from 0 to 30 points. Dementia can be graded according to the Condensed Mental State Scale, with mild dementia scoring 21-26, moderate dementia 11-20, and severe dementia 0-10
Psychological symptoms
The Neuropsychiatric Scale (NPI) is also a suitable tool for assessing NPS in patients with MBI. The Neuropsychiatric Scale is a scale developed by Cummings et al. to assess NPS in dementia patients, including hallucinations, delusions, agitation/aggression, anxiety, depression, euphoria, loss, disinhibition, abnormal movement, appetite disorders, sleep and nocturnal behavior disorders. The Chinese version of neuropsychiatric scale has good reliability and validity with Cronbach's α coefficient of 0.851, bias coefficient of 0.83, and total retest reliability of 0.86. The neuropsychiatric scale is easy to use and provides a way for semi-structured interviews to distinguish symptoms of inhibition from symptoms of apathy. Neuropsychiatric scale patient scores ranged from 0-144, caregiver pain scores ranged from 0-60, the lower the score the better
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