Yesavage Jerome, Hoblyn Jennifer, Friedman Leah, Mumenthaler Martin, Schneider Bret, O'Hara Ruth
Palo Alto Veterans Affairs Health Care System, Palo Alto, CA 94304, USA.
J Gerontol B Psychol Sci Soc Sci. 2007 Jun;62 Spec No 1:11-8. doi: 10.1093/geronb/62.special_issue_1.11.
In this article, we review current research regarding diagnosis of cognitive impairment in nondemented adults and discuss why medications and cognitive training together may be more beneficial than either alone. We also review potential cognitive enhancers and future research challenges. There are major reasons for such research: (a) Large numbers of older adults without dementia but with cognitive problems are not treatable with current cognitive training techniques; (b) some medications offer a rationale (i.e., cognitive enhancement) and some evidence that they might be a useful adjunct; and (c) there are unanswered questions about which population to target, which medications to use, how to administer them, and issues regarding tolerance and use of appropriate (active) placebo controls. As the number of cognitively impaired older adults grows, it is likely that there will be pressure to treat more broadly with both medications and cognitive training.
在本文中,我们回顾了当前关于非痴呆成年人认知障碍诊断的研究,并讨论了为何药物治疗与认知训练相结合可能比单独使用其中任何一种更有益。我们还回顾了潜在的认知增强剂以及未来的研究挑战。进行此类研究有几个主要原因:(a)大量没有痴呆但有认知问题的老年人无法通过当前的认知训练技术进行治疗;(b)一些药物提供了一种理论依据(即认知增强),并且有一些证据表明它们可能是有用的辅助手段;(c)关于针对哪些人群、使用哪些药物、如何给药以及耐受性和使用适当(活性)安慰剂对照的问题仍未得到解答。随着认知受损老年人数量的增加,很可能会有更大的压力促使人们更广泛地使用药物治疗和认知训练。