Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia.
Western Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences & Centre for Medical Research, University of Western Australia and Royal Perth Hospital, Australia; Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Australia.
Am J Geriatr Psychiatry. 2015 Apr;23(4):360-372. doi: 10.1016/j.jagp.2014.04.002. Epub 2014 Apr 12.
The role of cognition-focused interventions in reducing cognitive decline in older people remains uncertain. This study aimed to clarify whether a group cognitive activity (CA) strategy-training program would decrease the 2-year rate of cognitive decline of people with mild cognitive impairment (MCI).
Randomized controlled trial.
One study site.
160 older adults with MCI ≥65 years of age (mean: 75, SD: 5.8).
Five-week CA strategy training or a control nonspecific educational program. The primary outcome measure was change from baseline in the total score on the Cambridge Cognitive Examination-Revised (CAMCOG-R). Secondary outcomes of interest included changes in memory, attention, executive functions, mood, and quality of life. Endpoints were collected 10, 52, and 104 weeks post baseline.
Intention to treat analysis identified no significant difference in CAMCOG-R scores over time between the two groups (mean difference: -0.36, 95% CI: -1.02,0.29) or across secondary outcome measures. The exceptions were better performance of the CA group on immediate attention (Digit Span Forwards, adjusted mean difference: 0.15, 95% CI: 0.01,0.30) and better quality of life (adjusted mean difference: 0.57, 95% CI: 0.10,1.04) compared with controls.
The devised program of CA did not improve general cognitive performance of older adults with MCI over a period of 2 years. Although favorable, the beneficial effects of the intervention on attention and quality of life were small, and of uncertain significance.
认知焦点干预在减缓老年人认知能力下降方面的作用仍不确定。本研究旨在阐明小组认知活动（CA）策略训练方案是否会降低轻度认知障碍（MCI）患者的 2 年认知下降率。
随机对照试验。
一个研究地点。
160 名年龄≥65 岁的 MCI 老年人（平均年龄：75 岁，标准差：5.8 岁）。
为期 5 周的 CA 策略培训或非特异性教育对照组。主要结局测量指标是剑桥认知考试修订版（CAMCOG-R）总分的基线变化。感兴趣的次要结局包括记忆、注意力、执行功能、情绪和生活质量的变化。终点在基线后 10、52 和 104 周收集。
意向治疗分析表明，两组间 CAMCOG-R 评分随时间无显著差异（平均差异：-0.36，95%置信区间：-1.02，0.29），或在次要结局测量上无显著差异。例外的是 CA 组在即时注意力（数字跨度向前，调整平均差异：0.15，95%置信区间：0.01，0.30）和生活质量（调整平均差异：0.57，95%置信区间：0.10，1.04）方面表现更好，与对照组相比。
在 2 年的时间里，设计的 CA 方案并没有改善 MCI 老年人的一般认知表现。尽管有益，但干预对注意力和生活质量的有益影响较小，且意义不确定。
