School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
School of Nursing and Midwifery, University of Wollongong, Wollongong, New South Wales, Australia.
Am J Geriatr Psychiatry. 2015 Apr;23(4):335-359. doi: 10.1016/j.jagp.2014.04.009. Epub 2014 May 14.
The aim of this study was to assess the efficacy of cognitive training, specifically computerized cognitive training (CCT) and virtual reality cognitive training (VRCT), programs for individuals living with mild cognitive impairment (MCI) or dementia and therefore at high risk of cognitive decline. After searching a range of academic databases (CINHAL, PSYCinfo, and Web of Science), the studies evaluated (N = 16) were categorized as CCT (N = 10), VRCT (N = 3), and multimodal interventions (N = 3). Effect sizes were calculated, but a meta-analysis was not possible because of the large variability of study design and outcome measures adopted. The cognitive domains of attention, executive function, and memory (visual and verbal) showed the most consistent improvements. The positive effects on psychological outcomes (N = 6) were significant reductions on depressive symptoms (N = 3) and anxiety (N = 2) and improved perceived use of memory strategy (N = 1). Assessments of activities of daily living demonstrated no significant improvements (N = 8). Follow-up studies (N = 5) demonstrated long-term improvements in cognitive and psychological outcomes (N = 3), and the intervention groups showed a plateau effect of cognitive functioning compared with the cognitive decline experienced by control groups (N = 2). CCT and VRCT were moderately effective in long-term improvement of cognition for those at high risk of cognitive decline. Total intervention time did not mediate efficacy. Future research needs to improve study design by including larger samples, longitudinal designs, and a greater range of outcome measures, including functional and quality of life measures, to assess the wider effect of cognitive training on individuals at high risk of cognitive decline.
本研究旨在评估认知训练的效果，特别是计算机化认知训练（CCT）和虚拟现实认知训练（VRCT），对患有轻度认知障碍（MCI）或痴呆症且认知能力下降风险较高的个体的效果。在搜索了一系列学术数据库（CINHAL、PSYCinfo 和 Web of Science）后，评估的研究（N=16）被分为 CCT（N=10）、VRCT（N=3）和多模态干预（N=3）。计算了效应大小，但由于研究设计和采用的结果测量指标的巨大差异，无法进行荟萃分析。注意力、执行功能和记忆（视觉和言语）等认知领域的改善最为一致。对心理结果（N=6）的积极影响显著降低了抑郁症状（N=3）和焦虑（N=2），并改善了对记忆策略的感知使用（N=1）。对日常生活活动的评估没有显示出显著的改善（N=8）。随访研究（N=5）显示认知和心理结果的长期改善（N=3），与对照组经历的认知衰退相比，干预组的认知功能表现出平台效应（N=2）。CCT 和 VRCT 在认知衰退风险较高的人群中认知功能的长期改善方面具有中等效果。总干预时间不能介导疗效。未来的研究需要通过包括更大的样本量、纵向设计和更广泛的结果测量指标，包括功能和生活质量测量指标，来改善研究设计，以评估认知训练对认知衰退风险较高的个体的广泛影响。
