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认知加工速度训练对新增日常生活活动能力困难发展及抑郁症状减轻的影响:来自IHAMS随机对照试验的结果

The effect of cognitive speed of processing training on the development of additional IADL difficulties and the reduction of depressive symptoms: results from the IHAMS randomized controlled trial.

作者信息

Wolinsky Fredric D, Vander Weg Mark W, Howren M Bryant, Jones Michael P, Dotson Megan M

机构信息

The University of Iowa, Iowa City, USA

Iowa City VA Health Care System, IA, USA.

出版信息

J Aging Health. 2015 Mar;27(2):334-54. doi: 10.1177/0898264314550715. Epub 2014 Sep 19.

Abstract

OBJECTIVE

We evaluated the effects of cognitive speed of processing training (SOPT) on the development of additional Instrumental Activities of Daily Living (IADL) difficulties and the reduction of depressive symptoms in the Iowa Healthy and Active Minds Study (IHAMS).

METHOD

Six hundred eighty-one patients were randomized to 4 groups: 10 hr of on-site SOPT, 10 hr of on-site SOPT plus 4 hr of boosters, 10 hr of at-home SOPT, or 10 hr of on-site attention-control (crossword puzzles). Developing additional difficulties with IADLs and reductions in depressive symptoms 1 year later were evaluated using multiple logistic regression.

RESULTS

The on-site SOPT with boosters group had reduced odds of developing additional difficulties with IADLs (adjusted odds ratio [AOR] = 0.45, p = .044) compared with attention-controls. The on-site SOPT with boosters group also had increased odds of reduced depressive symptom levels (AOR = 2.93, p = .003) compared with attention-controls.

DISCUSSION

These findings provide evidence that SOPT transfers beyond the cognitive skills trained to meaningful downstream improvements in the lives of middle-aged and older adults.

摘要

目的

在爱荷华健康与活跃思维研究(IHAMS)中,我们评估了加工速度认知训练(SOPT)对日常生活工具性活动(IADL)出现更多困难的发展情况以及抑郁症状减轻的影响。

方法

681名患者被随机分为4组:10小时现场SOPT训练、10小时现场SOPT训练加4小时强化训练、10小时居家SOPT训练或10小时现场注意力控制训练(填字游戏)。使用多重逻辑回归评估1年后IADL出现更多困难的情况以及抑郁症状的减轻情况。

结果

与注意力控制组相比,接受强化训练的现场SOPT组出现IADL更多困难的几率降低(调整后的优势比[AOR]=0.45,p=0.044)。与注意力控制组相比,接受强化训练的现场SOPT组抑郁症状水平降低的几率也增加(AOR=2.93,p=0.003)。

讨论

这些发现提供了证据,表明SOPT的影响不仅限于所训练的认知技能,还能对中年及老年人的生活产生有意义的下游改善。

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