問題詳情

As a neuropsychiatric symptom, apathy is a strong predictor of the progression of theillness that has a significant influence on the quality of life of both the patients with dementiaand their caregivers. Patients with symptoms of apathy are characterized by decreasedgoal-oriented motor behavior, decreased goal-oriented cognition and decreased affectivereaction. Apathy plays an important role in the reduction of goal-directed behaviors andself-generated motivation. In addition, studies have considered apathy to be a symptomassociated with the loss of emotional feelings.Previous studies have reported symptoms of apathy to be commonly present in patientswith dementia, especially those who reside in a long-term nursing care home. Due to the lackof initiative and interest in their environment, patients with apathy often have seriousrestrictions on social participation. The presence of apathy, a neuropsychiatric symptom thatappears during the progression of dementia, may accelerate the deterioration of dementia andcan deprive patients of normal activities and reduce levels of consciousness. Apathy hasbecome an important factor that can influence patients’ rehabilitation with dementia. However,due to the heavy burden and emotional stress of providing caregiving for older people withdementia, as well as the difficulty to identify symptoms of apathy, it can be overlooked bycaregivers, resulting in suboptimal care. During routine care in dementia, apathy may fail toattract a comparable level of attention to other symptoms, such as memory deterioration,aggression, and agitation. Thus, older people with apathy may sit in solitude, experiencingboredom, with limited interaction, which may in turn exacerbate symptoms of apathy.Previous research has confirmed that apathy can have a negative impact on an individual’soverall quality of life, impair the treatment response and increase burden on the caregiver.Although apathy is the most common symptom in patients with dementia, there iscurrently no definitive treatment for this symptom in dementia. Drug therapy such as ritalincan only improve or relieve the symptoms for a certain period of time. Moreover, there arepresently no approved pharmacological guidelines for management of the symptoms ofapathy and insufficient evidence to substantiate the efficacy of any drugs. With theselimitations and side effects of drug therapy, which can place a heavy financial burden onfamilies, an increasing number of academics have suggested that non-pharmacologicalinterventions may have a role to play in the management of the dementia. To date, however,studies of non-pharmacological intervention approaches in dementia care are lacking.Several studies have specifically examined the effects of music as a therapy in themanagement of symptoms of dementia, suggesting the positive effect in the treatment ofanxiety, irritability and memory impairment. However, only a few publishednon-pharmacological treatment trials have specifically aimed at relieving symptoms of apathy.When listening to music, the reticular structures in the brain stem receive impulses fromthe body, viscera and other sensory systems. After integration and adjustment, the impulsesreach the cerebral cortex through the thalamus with no specificity, which can cause a reaction.Via transmission of the stimulation to the cerebrum through the auditory system, music playsa potentially important role in the regulation of the central nervous system and emotionaladjustment; it can control the internal and external physiological reactions and influenceendocrine function. Simultaneously, in the degenerative process of cerebral function, the partof brain that is associated with music programs is relatively well preserved. Thus, the cerebralcortex has been shown to be sensitive to the stimulation and reflexes associated with music,promoting the conduction of the peripheral nerve pathway when affected by musicalinterventions.Despite limited evidence of the efficacy of music interventions in the management ofpsychological symptoms in older people, no study to date has specifically looked at theeffectiveness of music interventions in the management of symptoms of apathy associatedwith dementia. It was therefore the main aim of our study was to explore the effect of groupmusic intervention on the motor affection and cognitive behaviors of older people inresidential homes with symptoms of apathy associated with dementia.
39. What is the main problem of treating apathy in dementia that the passage intends to identify?
(A) There has been no effective medical treatment for apathy in patients with dementia.
(B) Patients with dementia who reside in nursing homes are more likely to have symptomsof apathy.
(C) It is difficult to detect apathy since it develops along with other more easilyrecognized symptoms.
(D) The potential impact music has on treating apathy in dementia has not beenextensively investigated.[!--empirenews.page--]

參考答案

答案：D
難度：適中0.5
統計：A(0),B(0),C(0),D(0),E(0)

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