Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China.
Clin Interv Aging. 2013;8:623-33. doi: 10.2147/CIA.S45726. Epub 2013 Jun 7.
Improving the situation in older adults with cognitive decline and evidence of cognitive rehabilitation is considered crucial in long-term care of the elderly. The objective of this study was to implement a computerized errorless learning-based memory training program (CELP) for persons with early Alzheimer's disease, and to compare the training outcomes of a CELP group with those of a therapist-led errorless learning program (TELP) group and a waiting-list control group.
A randomized controlled trial with a single-blind research design was used in the study. Chinese patients with early Alzheimer's disease screened by the Clinical Dementia Rating (score of 1) were recruited. The subjects were randomly assigned to CELP (n = 6), TELP (n = 6), and waiting-list control (n = 7) groups. Evaluation of subjects before and after testing, and at three-month follow-up was achieved using primary outcomes on the Chinese Mini-Mental State Examination, Chinese Dementia Rating Scale, Hong Kong List Learning Test, and the Brief Assessment of Prospective Memory-Short Form. Secondary outcomes were the Modified Barthel Index, Hong Kong Lawton Instrumental Activities of Daily Living Scale, and Geriatric Depression Scale-Short Form. The data were analyzed using Friedman's test for time effect and the Kruskal-Wallis test for treatment effect.
Positive treatment effects on cognition were found in two errorless learning-based memory groups (ie, computer-assisted and therapist-led). Remarkable changes were shown in cognitive function for subjects receiving CELP and emotional/daily functions in those receiving TELP.
Positive changes in the cognitive function of Chinese patients with early Alzheimer's disease were initially found after errorless training through CELP. Further enhancement of the training program is recommended.
改善认知能力下降和认知康复证据的老年患者的状况被认为是老年人长期护理的关键。本研究旨在为早期阿尔茨海默病患者实施基于无错误学习的计算机记忆训练计划(CELP),并比较 CELP 组、治疗师主导的无错误学习计划(TELP)组和等待名单对照组的训练结果。
采用单盲研究设计的随机对照试验。通过临床痴呆评定量表(评分 1)筛选出中国早期阿尔茨海默病患者。将患者随机分配到 CELP(n=6)、TELP(n=6)和等待名单对照组(n=7)。采用简易精神状态检查量表、中文版痴呆评定量表、香港列表学习测验和简易前瞻性记忆评估-短式量表对患者进行测试前、测试后和 3 个月随访评估。次要结果为改良巴氏指数、香港 Lawton 工具性日常生活活动量表和老年抑郁量表-短式量表。采用 Friedman 检验进行时间效应分析,采用 Kruskal-Wallis 检验进行治疗效应分析。
两种基于无错误学习的记忆训练组(即计算机辅助和治疗师主导)对认知均有积极的治疗效果。接受 CELP 的患者认知功能明显改善,接受 TELP 的患者情绪/日常生活功能明显改善。
初步发现中国早期阿尔茨海默病患者在接受 CELP 无错误训练后认知功能发生积极变化。建议进一步增强训练计划。