CoRPS, Faculty of Social and Behavioural Sciences, Tilburg University, The Netherlands.
J Int Neuropsychol Soc. 2011 Mar;17(2):256-66. doi: 10.1017/S1355617710001530. Epub 2010 Dec 21.
This study investigated the specific patient factors that predict responsiveness to a cognitive rehabilitation program. The program has previously been demonstrated to be successful at the group level in patients with gliomas, but it is unclear which patient characteristics optimized the effect of the intervention at the individual level. Four categories of possible predictors of improvement were selected for evaluation: sociodemographic and clinical variables, self-reported cognitive symptoms, and objective neuropsychological test performance. Hierarchical logistic regression analyses were conducted, beginning with the most accessible (sociodemographic) variables and ending with the most difficult (baseline neuropsychological) to identify in clinical practice. Nearly 60% of the participants of the intervention were classified as reliably improved. Reliable improvement was predicted by age (p = .003) and education (p = .011). Additional results suggested that younger patients were more likely to benefit specifically from the cognitive rehabilitation program (p = .001), and that higher education was also associated with improvement in the control group (p = .024). The findings are discussed in light of brain reserve theory. A practical implication is that cognitive rehabilitation programs should take the patients' age into account and, if possible, adapt programs to increase the likelihood of improvement among older participants.
本研究调查了哪些特定的患者因素可预测认知康复计划的反应性。该计划此前已在脑胶质瘤患者的群体水平上被证明是成功的，但尚不清楚哪些患者特征在个体水平上优化了干预效果。选择了四类可能的改善预测因子进行评估：社会人口统计学和临床变量、自我报告的认知症状和客观神经心理学测试表现。进行了分层逻辑回归分析，从最易获取的（社会人口统计学）变量开始，以最难以获取的（基线神经心理学）变量结束，以确定哪些变量可以在临床实践中预测改善。近 60%的干预参与者被归类为可靠改善。可靠改善由年龄（p =.003）和教育程度（p =.011）预测。其他结果表明，年龄较小的患者更有可能特别受益于认知康复计划（p =.001），较高的教育程度也与对照组的改善有关（p =.024）。研究结果根据大脑储备理论进行了讨论。一个实际的影响是认知康复计划应该考虑到患者的年龄，并尽可能地调整计划，以增加老年参与者改善的可能性。
