Positive Impact of Holistic Nursing on Cognitive Impairment and Psychiatric Symptoms in Patients With Alzheimer's Disease

Abstract

Background: Alzheimer's Disease (AD) affects millions of elderly individuals worldwide and has been clinically recognized as one of the most significant disorders compromising quality of life in late-stage human development. The objective of this study is to systematically evaluate the influence of holistic nursing (HN) on patients with AD, thereby providing evidence-based references for clinical practice.

Methods: A total of 105 patients with AD hospitalized in our hospital between January 2023 and January 2024 were enrolled for prospective analysis. Among them, 58 received conventional care (control group), and 47 received HN (observation group). Before and following the nursing interventions, both groups underwent assessment using the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Montreal Cognitive Assessment (MoCA), and Self-rating Anxiety/Depression Scales (SAS/SDS). In addition, neurotransmitter levels and neuroinflammatory markers were measured using enzyme-linked immunosorbent assay and fully automated chemiluminescent immunoassay. Treatment compliance, incidence of adverse events, and family satisfaction were also recorded and compared between the two groups.

Results: After nursing interventions, the observation group demonstrated significantly higher MMSE and MoCA scores compared to the control group. Conversely, NPI, ADAS-cog, SAS, and SDS scores were notably lower in the observation group (p < 0.05). Furthermore, neurotransmitter levels were significantly elevated in the observation group, while the concentrations of central nervous system-specific protein β (S100β) and interleukin-1β (IL-1β) were significantly reduced (p < 0.05). Although the incidence of adverse events did not differ significantly between the two groups (p > 0.05), the observation group exhibited higher treatment compliance and greater family satisfaction (p < 0.05).

Conclusion: HN effectively improves cognitive function and alleviates psychiatric symptoms in AD patients, supporting its recommendation for clinical application.

Clinical trial registration: No. NCT06868004.

Fig. 1.

Flowchart of the screening process for research participants.

Fig. 2.

Comparison of cognitive function and psychiatric symptoms between groups. (a) Comparison of MMSE. (b) Comparison of NPI. (c) Comparison of ADAS-cog. (d) Comparison of MoCA. ^*⁣**p 0.001, comparison of post-nursing with pre-nursing data within the same group; ^#⁢#⁢#p 0.001, comparison of post-nursing data in the observation group with that in the control group. MMSE, Mini-Mental State Examination; NPI, Neuropsychiatric Inventory; ADAS-cog, Alzheimer’s Disease Assessment Scale-Cognitive Subscale; MoCA, Montreal Cognitive Assessment.

Fig. 3.

Comparison of psychological state between groups. (a) Comparison of SAS. (b) Comparison of SDS. ^*⁣**p 0.001, comparison of post-nursing data with pre-nursing data within the same group; ^#⁢#⁢#p 0.001, comparison of post-nursing data in the observation group with that in the control group. SAS/SDS, Self-rating Anxiety/Depression Scale.

Fig. 4.

Comparison of neurotransmitter levels between groups. (a) Comparison of DA. (b) Comparison of Ach. (c) Comparison of 5-HT. (d) Comparison of GABA. ^*⁣**p 0.001, comparison of post-nursing data with pre-nursing data within the same group; ^#⁢#⁢#p 0.001, comparison of post-nursing data in the observation group with that in the control group. DA, Dopamine; Ach, acetylcholine; 5-HT, 5-hydroxytryptamine; GABA, $\gamma$-aminobutyric acid.

Fig. 5.

Comparison of neuroinflammatory markers between groups. (a) Comparison of S100$\beta$. (b) Comparison of Hcy. (c) Comparison of IL-1$\beta$. ^*⁣**p 0.001, comparison of post-nursing data with pre-nursing data within the same group; ^#⁢#⁢#p 0.001, comparison of post-nursing data in the observation group with that in the control group. S100$\beta$, Central nervous system-specific protein $\beta$; Hcy, homocysteine; IL-1$\beta$, interleukin-1$\beta$.