University of Michigan School of Nursing, Ann Arbor, Michigan 48109, USA.
J Card Fail. 2011 Oct;17(10):832-43. doi: 10.1016/j.cardfail.2011.06.650.
Many patients with heart failure (HF) have cognitive deficits, including memory loss.
The aim of this study was to evaluate the efficacy of a cognitive training intervention on memory (primary outcome), working memory, psychomotor speed, executive function, and performance of cognitive activities and instrumental activities of daily living (IADLs).
Forty patients with HF were randomly assigned to the computerized plasticity-based cognitive training intervention called Brain Fitness or to the health education active control intervention. Advanced practice nurses made weekly home visits to assess symptoms and monitor intervention adherence. Patients completed demographic and clinical data (baseline), neuropsychologic tests (baseline and 8 and 12 weeks), and measures of cognitive and IADLs performance (baseline and 12 weeks) and satisfaction (12 weeks). Linear mixed models analyses indicated a significant group by time interaction for delayed recall memory (P = .032) and a significant time effect for total (list learning) (P < .001) and delayed (P = .015) recall memory, psychomotor speed (P = .029), and performance of IADLs (P = .006). Intervention adherence and patient satisfaction were high.
To our knowledge, this was the first test of Brain Fitness in HF. Although it was a preliminary study with limitations, results support the need for a larger randomized controlled trial to determine whether the memory loss of HF is amenable to plasticity-based interventions.
许多心力衰竭（HF）患者存在认知缺陷，包括记忆力减退。
本研究旨在评估认知训练干预对记忆力（主要结局）、工作记忆、运动速度、执行功能以及认知活动和日常生活活动（IADLs）表现的疗效。
40 名 HF 患者被随机分配到基于计算机的可塑性认知训练干预（称为“大脑健身”）或健康教育主动对照干预。高级执业护士每周进行家访，以评估症状并监测干预依从性。患者完成人口统计学和临床数据（基线）、神经心理学测试（基线和 8 周、12 周）以及认知和 IADLs 表现（基线和 12 周）和满意度（12 周）的测量。线性混合模型分析表明，延迟回忆记忆的组间时间交互具有统计学意义（P=0.032），总（列表学习）（P<0.001）和延迟（P=0.015）回忆记忆、运动速度（P=0.029）以及 IADLs 表现（P=0.006）的时间效应具有统计学意义。干预依从性和患者满意度均较高。
据我们所知，这是首次在 HF 中测试“大脑健身”。尽管这是一项具有局限性的初步研究，但结果支持需要进行更大规模的随机对照试验，以确定 HF 的记忆丧失是否可以通过基于可塑性的干预来改善。
