Chandler M J, Parks A C, Marsiske M, Rotblatt L J, Smith G E
Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
University of Florida, Gainesville, FL, USA.
Neuropsychol Rev. 2016 Sep;26(3):225-251. doi: 10.1007/s11065-016-9330-4. Epub 2016 Sep 8.
Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.
轻度认知障碍（MCI）的认知干预旨在改善该病症的认知症状。认知干预可能会也可能不会从认知结果推广到日常生活中。这项系统综述和荟萃分析旨在评估与对照组相比，MCI认知干预对推广性结果指标（日常生活活动能力（ADL）、情绪、生活质量（QOL）和元认知）的影响，而不仅仅是对认知结果的影响。遵循PRISMA指南。使用MEDLINE和PsychInfo作为数据源来查找与MCI个体认知干预相关的参考文献。认知干预研究需要有一个对照组或替代治疗比较组才能纳入。30篇文章符合标准，包括6项计算机化认知干预、14项基于治疗师的干预和10项多模式（即认知干预加额外干预）研究。ADL（d = 0.23）、情绪（d = 0.16）和元认知结果（d = 0.30）总体上有小但显著的中位数效应，而QOL（d = 0.10）则没有。与对照组相比，计算机化研究似乎对情绪（抑郁、焦虑和冷漠）有益，而基于治疗师的干预和多模式干预对ADL和元认知结果的影响比对照条件更大。令人鼓舞的是，MCI的认知干预可能会影响日常生活，但仍需要更多的研究。当前的综述和荟萃分析受到以下因素的限制：我们仅使用了PsychInfo和MEDLINE数据库，无法阅读全文非英文文章，并且仅依赖已发表的数据来完成效应量分析。
