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简单计算和大声朗读认知训练对老年术后人群的有益影响:一项随机对照试验的研究方案

The beneficial effects of cognitive training with simple calculation and reading aloud in an elderly postsurgical population: study protocol for a randomized controlled trial.

作者信息

Kulason Kay, Nouchi Rui, Hoshikawa Yasushi, Noda Masafumi, Okada Yoshinori, Kawashima Ryuta

机构信息

Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, 980-8575, Japan.

Creative Interdisciplinary Research Division, Frontier Research Institute for Interdisciplinary Science (FRIS), Tohoku University, 4-1 Seiryocho, Aobaku, Sendai, 980-8578, Japan.

出版信息

Trials. 2016 Jul 22;17:334. doi: 10.1186/s13063-016-1476-0.

Abstract

BACKGROUND

This project proposes a pilot study to investigate the positive healing effects of cognitive training with simple arithmetic and reading aloud on elderly postsurgical patients. Elderly patients undergoing surgery have an increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery has aged. Little effort has been expended, however, to find treatments for POCD. Learning therapy, which consists of a combination of reading aloud and solving simple arithmetic problems, was developed in Japan as a treatment for Alzheimer's Disease to improve cognitive functions. Because patients with Alzheimer's Disease experience similar issues as those with POCD in learning, memory, and processing speed, a cognitive intervention based on the learning-therapy treatments used for Alzheimer's Disease could show advantageous outcomes for those at risk of POCD.

METHODS/DESIGN: Cognitive function will be measured before and after surgery using three different tests (Mini-Mental Status Exam, Frontal Assessment Battery, and Cogstate computerized tests). Subjects will be randomly divided into two groups-one that receives a Simple Calculation and Reading Aloud intervention (SCRA) and a waitlisted control group that does not receive SCRA. To measure cognition before and after the intervention, the previously mentioned three tests will be used. The obtained data will be analyzed using statistical tests such as ANCOVA to indicate whether the cognitive intervention group has made improvements in their cognitive functions. In addition, questionnaires will also be administered to collect data on mental and emotional statuses.

DISCUSSION

This report will be the first pilot study to investigate the beneficial effects of SCRA on elderly surgical patients. Previous studies have shown sufficient evidence on the effectiveness of learning therapy in healthy elderly people and in those with Dementia. Therefore, this study will clarify whether SCRA can improve cognitive function in the more specialized group of elderly surgical patients.

TRIAL REGISTRATION

University Hospital Medical Information Network Clinical Trial Registry, UMIN000019832 . Registered on 18 November 2015.

摘要

背景

本项目提议开展一项试点研究,以调查简单算术和大声朗读的认知训练对老年术后患者的积极康复效果。接受手术的老年患者术后认知功能下降(POCD)的风险增加,POCD是一种术后学习、记忆和处理速度大幅降低的病症。由于老年患者更易出现POCD症状,且随着接受手术的人群老龄化,其发病率正在上升。然而,为POCD寻找治疗方法的努力却很少。学习疗法由大声朗读和解决简单算术问题组成,在日本被开发用于治疗阿尔茨海默病以改善认知功能。由于阿尔茨海默病患者在学习、记忆和处理速度方面存在与POCD患者类似的问题,基于用于阿尔茨海默病的学习疗法进行的认知干预可能对有POCD风险的人产生有利结果。

方法/设计:将在手术前后使用三种不同测试(简易精神状态检查表、额叶评估量表和Cogstate计算机化测试)测量认知功能。受试者将被随机分为两组,一组接受简单计算和大声朗读干预(SCRA),另一组为未接受SCRA的候补对照组。为测量干预前后的认知情况,将使用上述三种测试。所获数据将使用协方差分析等统计测试进行分析,以表明认知干预组在认知功能方面是否有所改善。此外,还将发放问卷以收集有关心理和情绪状态的数据。

讨论

本报告将是第一项调查SCRA对老年手术患者有益效果的试点研究。先前的研究已显示出充分证据证明学习疗法对健康老年人和痴呆症患者有效。因此,本研究将阐明SCRA是否能改善老年手术患者这一更特殊群体的认知功能。

试验注册

大学医院医学信息网络临床试验注册中心,UMIN000019832。于2015年11月18日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adb0/4971755/b6077eefcbdb/13063_2016_1476_Fig1_HTML.jpg

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