对于有患痴呆症风险的老年人，认知变化与积极的生活方式的正相关性比与训练干预的正相关性更强：一项对照干预临床试验。
Cognitive change is more positively associated with an active lifestyle than with training interventions in older adults at risk of dementia: a controlled interventional clinical trial.
作者信息
Küster Olivia C, Fissler Patrick, Laptinskaya Daria, Thurm Franka, Scharpf Andrea, Woll Alexander, Kolassa Stephan, Kramer Arthur F, Elbert Thomas, von Arnim Christine A F, Kolassa Iris-Tatjana
机构信息
Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany.
Department of Psychology, TU Dresden, Dresden, Germany.
出版信息
BMC Psychiatry. 2016 Sep 8;16(1):315. doi: 10.1186/s12888-016-1018-z.
BACKGROUND
While observational studies show that an active lifestyle including cognitive, physical, and social activities is associated with a reduced risk of cognitive decline and dementia, experimental evidence from corresponding training interventions is more inconsistent with less pronounced effects. The aim of this study was to evaluate and compare training- and lifestyle-related changes in cognition. This is the first study investigating these associations within the same time period and sample.
METHODS
Fifty-four older adults at risk of dementia were assigned to 10 weeks of physical training, cognitive training, or a matched wait-list control condition. Lifestyle was operationalized as the variety of self-reported cognitive, physical, and social activities before study participation. Cognitive performance was assessed with an extensive test battery prior to and after the intervention period as well as at a 3-month follow-up. Composite cognition measures were obtained by means of a principal component analysis. Training- and lifestyle-related changes in cognition were analyzed using linear mixed effects models. The strength of their association was compared with paired t-tests.
RESULTS
Neither training intervention improved global cognition in comparison to the control group (p = .08). In contrast, self-reported lifestyle was positively associated with benefits in global cognition (p < .001) and specifically in memory (p < .001). Moreover, the association of an active lifestyle with cognitive change was significantly stronger than the benefits of the training interventions with respect to global cognition (ps < .001) and memory (ps < .001).
CONCLUSIONS
The associations of an active lifestyle with cognitive change over time in a dementia risk group were stronger than the effects of short-term, specific training interventions. An active lifestyle may differ from training interventions in dosage and variety of activities as well as intrinsic motivation and enjoyment. These factors might be crucial for designing novel interventions, which are more efficient than currently available training interventions.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier NCT01061489 . Registered February 2, 2010.
背景
尽管观察性研究表明，积极的生活方式，包括认知、身体和社交活动，与认知能力下降和痴呆风险降低有关，但相应训练干预的实验证据却更为不一致，效果也不那么显著。本研究的目的是评估和比较与训练及生活方式相关的认知变化。这是第一项在同一时间段和样本中研究这些关联的研究。
方法
54名有痴呆风险的老年人被分配到为期10周的体育训练、认知训练或匹配的等待名单对照组。生活方式通过研究参与前自我报告的认知、身体和社交活动的多样性来衡量。在干预期前后以及3个月随访时，使用广泛的测试组合评估认知表现。通过主成分分析获得综合认知指标。使用线性混合效应模型分析与训练及生活方式相关的认知变化。通过配对t检验比较它们关联的强度。
结果
与对照组相比，两种训练干预均未改善整体认知（p = 0.08）。相比之下，自我报告的生活方式与整体认知的改善呈正相关（p < 0.001），特别是在记忆方面（p < 0.001）。此外，积极的生活方式与认知变化的关联在整体认知（p < 0.001）和记忆（p < 0.001）方面明显强于训练干预的效果。
结论
在痴呆风险组中，积极的生活方式与随时间的认知变化的关联强于短期、特定训练干预的效果。积极的生活方式在活动剂量和多样性以及内在动机和乐趣方面可能与训练干预不同。这些因素可能对设计比目前可用的训练干预更有效的新型干预措施至关重要。
试验注册
ClinicalTrials.gov标识符NCT01061489。2010年2月2日注册。
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