Impact of Narrative Nursing and Cognitive Behavioral Rehabilitation on Cognitive Function and Anxiety in Patients With Alzheimer's Disease

Objective

Alzheimer's disease (AD) progressively impairs cognitive function and quality of life (QoL). Patients frequently experience anxiety, which may accelerate cognitive decline. This study aimed to investigate the effects of narrative nursing combined with cognitive behavioral rehabilitation on cognitive function and anxiety in AD patients.

Methods

In this randomized controlled trial, 172 AD patients were assigned to a control group (conventional care, n  = 86) or an observation group (additional 6‐month narrative nursing and cognitive behavioral rehabilitation, n  = 86). Outcomes were assessed at baseline and after the 6‐month intervention using validated Chinese versions of the Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Generalised Anxiety Disorder‐7 (GAD‐7), Alzheimer's Disease Cooperative Study–Activities of Daily Living (ADCS‐ADL), and Quality of Life in Alzheimer's Disease (QoL‐AD) scales.

Results

Baseline characteristics, including age (mean: 68.5 ± 10.2 years), sex distribution (57.6% men), body mass index (22.95 ± 3.44 kg/m ² ), disease duration (5.32 ± 0.79 years), and baseline cognitive scores (MMSE: 19.25 ± 2.88; MoCA: 17.00 ± 2.55), did not differ significantly between groups. After 6 months of intervention, the observation group demonstrated greater improvement in cognitive function (MMSE: F  = 4.461, p  = 0.039; MoCA: F  = 5.441, p  = 0.040), anxiety (GAD‐7: F  = 14.937, p  < 0.001), ADL (ADCS‐ADL: F  = 11.967, p  < 0.001), and QoL (QoL‐AD: F  = 7.307, p  < 0.001) than the control group. Adherence was high (92%), with no significant group differences. Missed sessions were primarily attributable to acute illness, transportation difficulties, or family commitments. Medication regimens (cholinesterase inhibitors, memantine, and antidepressants) remained stable between groups, with no significant interaction with the intervention.

Conclusion

Narrative nursing combined with cognitive behavioral rehabilitation can effectively increase cognitive function, reduce anxiety, and improve the ADL and QoL of patients with AD.

Trial Registration: ISRCTN10742199