Occurrence and Influencing Factors of Cognitive Impairment in Elderly Patients With Schizophrenia and

Third People's Hospital, Huzhou City, Zhejiang Province, China

Status: Completed

Conditions: Cognitive Impairment; Schizophrenia Disorders; Acceptance and Commitment Therapy

Treatments: Other: the conventional treatment group; Other: the ACT group

Study type: Interventional

Funder types: Other

Identifiers

NCT06949657

No. 2025-130

Details and patient eligibility

About

ACT combined with stratified intervention improved cognitive function and quality of life in elderly schizophrenia patients by enhancing psychological flexibility and family support.

Full description

This study analyzes factors influencing cognitive impairment and evaluates the efficacy of a stratified intervention combining Acceptance and Commitment Therapy (ACT) with these factors to improve cognitive function and quality of life. A total of 149 elderly patients with schizophrenia were enrolled, split into cognitive impairment (n = 86) and non-cognitive impairment (n = 63) groups. A combined case-control and randomized controlled trial design was employed. Logistic regression was used to identify independent risk factors. Cognitive impairment patients were randomly assigned to either the conventional treatment group (n = 39) or the ACT group (n = 39) for a 6-week intervention. Evaluation instruments included the AAQ-II (psychological flexibility), GSES (self-efficacy), FACES II-CV (family functioning), SSMI-C (internalized stigma), and SQLS (quality of life).

Enrollment: 78 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• (1)Meets the diagnostic criteria for schizophrenia as defined in the International Classification of Diseases, Tenth Revision (ICD-10);
• (2) age > 60 years;
• (3)possesses at least a primary school education, enabling independent completion of all questionnaires;
• (4) has been taking antipsychotic medication continuously and regularly for at least one year during the enrollment period, with current symptoms and disease status stabilized in the maintenance phase;
• (5)informed consent obtained from the patient or their family/guardian.

Exclusion criteria

• (1) Coexisting organic mental disorders, affective disorders, or similar conditions;
• (2) coexisting physical illnesses that may affect cognitive function, such as hepatic or renal dysfunction;
• (3) alcohol dependence or dependence on psychoactive substances;
• (4) receipt of electroconvulsive therapy within the past three months.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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78 participants in 2 patient groups

the conventional treatment group

Other group

Description:

Patients received conventional mental health education once weekly for 6 weeks, covering schizophrenia symptoms, treatment, and prognosis. Standard nursing care and antipsychotic medications (e.g., olanzapine, quetiapine) were maintained without additional psychological interventions.

Treatment:

Other: the conventional treatment group

the ACT group

Other group

Description:

Patients received ACT-based nursing interventions tailored to risk factors (e.g., age ≥70, long disease duration), including: ACT modules: Acceptance, cognitive defusion, mindfulness, values clarification, and committed action. Adjunct strategies: Family therapy, Tai Chi, and crisis planning. Frequency: Daily practice + 1-2 group sessions/week for 6 weeks. Goal: Enhance psychological flexibility, reduce stigma, and improve cognitive function.

Treatment:

Other: the ACT group