Wolinsky Fredric D, Vander Weg Mark W, Martin Rene, Unverzagt Frederick W, Ball Karlene K, Jones Richard N, Tennstedt Sharon L
Department of Health Management and Policy, College of Public Health, University of Iowa, 200 Hawkins Drive, E205 General Hospital, Iowa City, IA 52242, USA.
J Gerontol A Biol Sci Med Sci. 2009 Apr;64(4):468-72. doi: 10.1093/gerona/gln044. Epub 2009 Jan 30.
We evaluated the effects of three cognitive training interventions on depressive symptoms at 1 and 5 years.
Advanced Cognitive Training for Independent and Vital Elderly is a multisite randomized controlled trial (age >or= 65 years), with four groups (memory, reasoning, speed-of-processing, and no-contact control). Complete data were available for 2,014 (72%) and 1,516 (54%) of 2,802 participants at 1 and 5 years. Separate propensity score models adjusted for potential attrition bias. Clinically important increases in depressive symptoms were defined as: (a) Center for Epidemiological Studies-Depression scale (CES-D)-12 score increases >or=0.5 SD and (b) CES-D-12 score increases >or=1.0 SD. Multivariable logistic regression was used.
The speed-of-processing group (vs the no-contact control group) was 30% less likely to experience clinically important increases in depressive symptoms at 1-year (adjusted odds ratio [AOR] = 0.700, p = .012) and 5-year (AOR = 0.698, p = .023) posttraining for the >or=0.5 SD threshold. Similar results (AOR = .669 with p = .039 at 1 year; AOR = 0.651 with p = .059 at 5 years) were obtained for the >or=1.0 SD threshold. No differences were observed among the control, memory, or reasoning groups at either time period or at either threshold.
The speed-of-processing intervention reduced the risk of clinically important increases in depressive symptoms at 1- and 5-years postbaseline.
我们评估了三种认知训练干预措施在1年和5年时对抑郁症状的影响。
“独立和活力老年人高级认知训练”是一项多中心随机对照试验（年龄≥65岁），分为四组（记忆、推理、处理速度和无接触对照组）。在1年和5年时，2802名参与者中有2014名（72%）和1516名（54%）可获得完整数据。采用单独的倾向得分模型调整潜在的失访偏倚。抑郁症状临床上的重要增加定义为：（a）流行病学研究中心抑郁量表（CES-D）-12得分增加≥0.5标准差，以及（b）CES-D-12得分增加≥1.0标准差。使用多变量逻辑回归。
在训练后1年（调整优势比[AOR]=0.700，p=0.012）和5年（AOR=0.698，p=0.023），对于≥0.5标准差阈值，处理速度组（与无接触对照组相比）出现临床上重要抑郁症状增加的可能性降低30%。对于≥1.0标准差阈值，也获得了类似结果（1年时AOR=0.669，p=0.039；5年时AOR=0.651，p=0.059）。在任何时间段或任何阈值下，对照组、记忆组或推理组之间均未观察到差异。
处理速度干预降低了基线后1年和5年时临床上重要抑郁症状增加的风险。
