Wolinsky Fredric D, Unverzagt Frederick W, Smith David M, Jones Richard, Stoddard Anne, Tennstedt Sharon L
Center for Research in the Implementation of Innovative Strategies in Practice, VA Iowa City Health Care System, Iowa, USA.
J Gerontol A Biol Sci Med Sci. 2006 Dec;61(12):1324-9. doi: 10.1093/gerona/61.12.1324.
We evaluated the ability of the three cognitive training interventions (memory, reasoning, or speed of processing) fielded in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) multisite randomized controlled trial to protect against two thresholds of extensive decline in health-related quality of life (HRQoL) at 2 and 5 years post-training.
Adults aged 65 years or older (2802) were enrolled and randomized to three cognitive interventions or a no-contact control group. Data on 1804 participants were available at both the 2- and 5-year follow-ups. HRQoL was measured by the eight MOS 36-Item Short-Form Health Survey (SF-36) scales. Clinically relevant decline on each scale was defined as a drop of > or = 0.5 standard deviations from baseline. Extensive HRQoL decline was defined as clinically relevant drops on (i) > or = 4 SF-36 scales, and (ii) > or = 3 SF-36 scales, and was assessed using multiple logistic regressions, weighted to adjust for potential attrition bias. Results. At 2 years post-training, 23.7% and 36.6% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. At 5 years post-training, 32.9% and 47.3% had clinically relevant drops on > or = 4 and > or = 3 SF-36 scales, respectively. Participants in the speed of processing intervention arm were significantly less likely to have extensive HRQoL decline compared to participants in the control group regardless of the threshold or time period, whereas participants in the memory and reasoning intervention arms were significantly less like to have extensive HRQoL decline only at 5 years post-training and only at the lower threshold. Conclusion. The effect of the speed of processing intervention was stronger and evident earlier than those for the memory and reasoning interventions. This result stems from the speed of processing intervention being the most procedural intervention, operating through sensory-motor elaboration and repetition, bringing about a broader pattern of regional brain activation. At 5 years post-training, however, all three interventions were successful in protecting against a lower threshold of age-related extensive declines in HRQoL.
我们评估了在“独立和活力老年人高级认知训练”（ACTIVE）多中心随机对照试验中开展的三种认知训练干预措施（记忆、推理或处理速度）在训练后2年和5年预防健康相关生活质量（HRQoL）出现两个广泛下降阈值的能力。
招募了2802名65岁及以上的成年人，并将他们随机分为三种认知干预组或无接触对照组。在2年和5年随访时可获得1804名参与者的数据。HRQoL通过八个MOS 36项简短健康调查（SF-36）量表进行测量。每个量表上具有临床意义的下降定义为相对于基线下降≥0.5个标准差。广泛的HRQoL下降定义为：（i）在≥4个SF-36量表上出现具有临床意义的下降，以及（ii）在≥3个SF-36量表上出现具有临床意义的下降，并使用多重逻辑回归进行评估，加权以调整潜在的失访偏倚。结果：在训练后2年，分别有23.7%和36.6%的参与者在≥4个和≥3个SF-36量表上出现具有临床意义的下降。在训练后5年，分别有32.9%和47.3%的参与者在≥4个和≥3个SF-36量表上出现具有临床意义的下降。无论阈值或时间段如何，处理速度干预组的参与者出现广泛HRQoL下降的可能性显著低于对照组的参与者，而记忆和推理干预组的参与者仅在训练后5年且仅在较低阈值时出现广泛HRQoL下降的可能性显著降低。结论：处理速度干预的效果比记忆和推理干预更强且更早显现。这一结果源于处理速度干预是最具程序性的干预措施，通过感觉运动精细化和重复起作用，导致更广泛的区域脑激活模式。然而，在训练后5年，所有三种干预措施都成功预防了与年龄相关的较低阈值的HRQoL广泛下降。
Zotero 插件