University of Alberta, Edmonton, Alberta, Canada.
Am J Speech Lang Pathol. 2013 Feb;22(1):126-45. doi: 10.1044/1058-0360(2012/11-0137). Epub 2012 Jul 30.
To evaluate the current state of research evidence related to cognitive interventions for individuals with Alzheimer's disease or related dementias.
A systematic search of the literature was conducted across 27 electronic databases based on a set of a priori questions, inclusion/exclusion criteria, and search parameters. Studies were appraised for methodological quality and categorized according to intervention technique and outcome (e.g., cognitive-communication impairment or activity limitation/participation restriction). Results were summarized and, when possible, analyzed quantitatively using indicators of treatment effect size.
Forty-three studies met criteria for inclusion in the review. The most commonly used cognitive intervention techniques used were errorless learning, spaced-retrieval training, vanishing cues, or verbal instruction/cueing. Most treatment outcomes were measured at the cognitive-communication impairment level of functioning and were generally positive. However, results should be interpreted cautiously because of methodological limitations across studies.
Research evidence to support the use of cognitive interventions for individuals with dementia is accumulating. Researchers are beginning to evaluate treatment efficacy, yet the focus tends to be on discovery, specifically, refining intervention variables that will facilitate optimal outcomes. Implications for clinical practice and avenues for future research are discussed.
评估与阿尔茨海默病或相关痴呆患者认知干预相关的研究证据现状。
根据一组事先确定的问题、纳入/排除标准和搜索参数，对 27 个电子数据库进行了系统的文献搜索。根据干预技术和结果（例如认知-交流障碍或活动受限/参与受限）对研究进行评估和分类。总结结果，并在可能的情况下使用治疗效果大小的指标进行定量分析。
43 项研究符合纳入标准。最常用的认知干预技术包括无错误学习、间隔检索训练、消失线索或口头指导/提示。大多数治疗结果都是在认知-交流障碍的功能水平上进行测量的，并且通常是积极的。然而，由于研究之间存在方法学限制，因此结果应谨慎解释。
支持痴呆患者使用认知干预的研究证据正在积累。研究人员开始评估治疗效果，但重点往往是发现，特别是细化干预变量，以促进最佳结果。讨论了对临床实践的影响和未来研究的途径。
