[[alternative]]Effects of dual-task intervention program on cognitive function, emotional distress, and life satisfaction for type 2 diabetes mellitus patients with mild cognitive impairment

[[abstract]]背景：全球第二型糖尿病合併輕度認知功能障礙個案的盛行率為45%，第二型糖尿病的長者會因輕度認知功能缺損造成日常記憶力與執行功能的改變，同時導致情緒困擾與生活滿意度的降低。過去研究指出執行雙重任務可以改善長者的注意力與執行功能，但較少研究探討運用雙重任務於第二型糖尿病合併輕度認知功能障礙個案的實證研究。目的：本研究主要為探討以雙重任務介入對第二型糖尿病合併輕度認知功能障礙個案的認知功能、情緒困擾與生活滿意度之改善情形。方法：本研究採類實驗兩組前、後測研究設計，以立意選樣方式，選取台北市一個社區據點與新北市四個社區據點的第二型糖尿病合併輕度認知功能障礙個案為研究對象。採用單盲非隨機分配，將台北市社區據點的研究對象分派為實驗組，新北市區據點的研究對象為對照組，前者16位、後者25位。實驗組介入團體的「雙重任務方案」，方案為每週一次，每次至少60分鐘，為期6週。其內容為暖身與緩和運動各5分鐘、伸展運動10分鐘、綜合認知運動課程40分鐘以及每週練習一次健走認知伴隨數學算數等活動。對照組則予一般常規指導。資料收集為介入前與介入後的面對面訪談問卷進行之。統計分析採SPSS 23.0版，進行GEE統計資料處理。 結果：本研究發現實驗組在方案介入後，其整體認知功能之整體聖路易心智狀態測驗(SLUMS)得分顯著高於對照組(p<0.001)；實驗組的注意力得分顯著高於對照組(p=0.004)；實驗組的執行功能得分顯著高於對照組(p=0.021)；實驗組的認知功能中的主觀記憶抱怨分數顯著低於對照組(p=0.008)；實驗組的認知功能中的日常記憶分數相較於對照組無顯著差異(p=0.078)；實驗組的情緒困擾分數相較於對照組無顯著差異(p=0.082)；實驗組的生活滿意度分數相較於對照組顯著較低(p=0.028)。結論：本研究支持第二型糖尿病合併輕度認知功能障礙個案接受雙重任務方案後，個體於認知功能改善的效果。本研究介入方案可作為發展社區的糖尿病個案進行雙重任務方案設計與規劃之參考。[[abstract]]Background：The prevalence rate of type 2 diabetes mellitus (T2DM) combined with mild cognitive impairment (MCI) is estimated to be approximately 45% worldwide. Older patients with T2DM may suffer from MCI, which may result in changes in their daily memory and executive functions, emotional distress, and reduced life satisfaction. Previous studies have shown that the execution of dual tasks can improve the attention and executive functions in older adults. However, there is a lack of empirical research investigating the effects of dual tasks in patients with T2DM combined with MCI.Aims and objectives：This study mainly focuses on investigating the effects of dual-task intervention on cognitive function, emotional distress, and life satisfaction in patients with T2DM combined with MCI.Methods：The study adopted a two-group, pre- and post-test study design. Patients with T2DM combined with MCI at a community care station in Taipei City and four community care stations in New Taipei City were selected as study subjects using purposive sampling. Subjects at the community care station in Taipei City were assigned to the experimental group (16 subjects) and subjects at the community care stations in New Taipei City were assigned to the control group (25 subjects) using single-blind non-randomized allocation. Subjects in the experimental group participated in a dual-task group intervention programme administered once per week for six weeks, with each session lasting at least 60 minutes. The intervention programme comprised the following activities: warm-up and cool-down exercises (5 minutes each), stretching exercises (10 minutes), combined physical and cognitive exercises (40 minutes), and weekly practice of dual-tasking that involved fast walking accompanied with arithmetic activities. Subjects in the control group received routine guidance. Experimental data were collected through pre- and post-intervention face-to-face interview questionnaires, and statistical analysis was performed in SPSS 23.0 using the generalized estimating equations (GEE) method.Results：Our results indicated as follows: The Saint Louis University Mental Status (SLUMS) examination score, a measure of the overall cognitive function, was significantly higher in the experimental group than in the control group (p < 0.001); The attention score of the experimental group was significantly higher than that of the control group (p = 0.004); The executive function score of the experimental group was significantly higher than that of the control group (p = 0.021); The subjective memory complaints (SMCs) score, a component of cognitive function, was significantly lower in the experimental group than in the control group (p = 0.008); The daily memory score, a component of cognitive function, was not significantly different between the experimental and control groups (p = 0.078); The emotional distress score was not significantly different between the experimental and control groups (p = 0.082); The life satisfaction score of the experimental group was significantly lower than that of the control group (p = 0.028).Conclusion：The results of this study demonstrate that dual-task intervention effectively improved cognitive function in patients with T2DM combined with MCI. Therefore, the intervention programme adopted in this study may serve as reference for the design and planning of dual-task intervention programmes for patients with diabetes in the community