Unverzagt Frederick W, Smith David M, Rebok George W, Marsiske Michael, Morris John N, Jones Richard, Willis Sherry L, Ball Karlene, King Jonathan W, Koepke Kathy Mann, Stoddard Anne, Tennstedt Sharon L
The Departments of Psychiatry, Indiana University School of Medicine, 1111 W. 10th Street, Suite PB 218A, Indianapolis, IN 46202, USA.
Curr Alzheimer Res. 2009 Aug;6(4):375-83. doi: 10.2174/156720509788929345.
This paper is based on a presentation made during the Indiana Alzheimer Disease Center's Symposium on Mild Cognitive Impairment on April 19, 2008. The results of the ACTIVE study (Advanced Cognitive Training for Independent and Vital Elderly) were presented at the symposium including review of previously published study findings. The ACTIVE study is a multicenter, randomized, controlled clinical trial that has been examining the long-term effectiveness of cognitive training on enhancing mental abilities (memory, reasoning, and attention) and preserving activities of daily living (managing finances, taking medication, using the telephone, and driving) in older adults. Six centers across the eastern United States enrolled nearly 3000 people initially. Participants underwent detailed assessments of mental and functional ability on multiple occasions over several years of follow-up. ACTIVE has shown positive effects of cognitive training at 5 years post-intervention for basic mental abilities, health-related quality of life, and improved ability to perform instrumental activities of daily living (IADL). A subgroup analysis through 2 years of follow-up suggested that subjects with mild cognitive impairment (MCI) did not benefit from memory training; however, they did benefit, to the same degree as cognitively normal participants, from training in reasoning and speed of processing. This finding suggests that MCI may interfere with a person's ability to benefit from some forms of cognitive enhancement. Limitations of ACTIVE and directions for future research are reviewed.
本文基于2008年4月19日在印第安纳州阿尔茨海默病中心轻度认知障碍研讨会上的一次演讲。会上展示了ACTIVE研究（针对独立且有活力的老年人的高级认知训练）的结果，包括对先前发表的研究结果的回顾。ACTIVE研究是一项多中心、随机、对照临床试验，一直在研究认知训练对提高老年人心理能力（记忆、推理和注意力）以及保持日常生活活动（理财、服药、使用电话和驾驶）的长期有效性。美国东部的六个中心最初招募了近3000人。在数年的随访中，参与者多次接受了心理和功能能力的详细评估。ACTIVE研究表明，干预后5年，认知训练对基本心理能力、与健康相关的生活质量以及执行日常生活工具性活动（IADL）的能力有积极影响。一项为期2年的随访亚组分析表明，轻度认知障碍（MCI）患者未从记忆训练中获益；然而，他们从推理和处理速度训练中获益的程度与认知正常的参与者相同。这一发现表明，MCI可能会干扰一个人从某些形式的认知增强中获益的能力。文中还回顾了ACTIVE研究的局限性以及未来研究的方向。
