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认知受损老年人的认知训练:一项评估平衡能力潜在改善情况的可行性研究

Cognitive Training among Cognitively Impaired Older Adults: A Feasibility Study Assessing the Potential Improvement in Balance.

作者信息

Smith-Ray Renae L, Irmiter Cheryl, Boulter Kristin

机构信息

Department of Health Analytics, Research, and Reporting, Walgreen Co., Deerfield, IL, USA; Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.

Loyola University Chicago , Chicago, IL , USA.

出版信息

Front Public Health. 2016 Oct 17;4:219. doi: 10.3389/fpubh.2016.00219. eCollection 2016.

Abstract

BACKGROUND

Emerging literature suggests that mobility and cognition are linked. Epidemiological data support a negative association between cognition and falls among cognitively intact older adults. A small number of intervention studies found that regimented cognitive training (CT) improves mobility among this population, suggesting that CT may be an under-explored approach toward reducing falls. To date, no studies have examined the impact of CT on balance among those who are cognitively impaired. The purpose of this study was to assess the feasibility of implementing a CT program among cognitively impaired older adults and examine whether there are potential improvements in balance following CT.

METHOD

A single group repeated measures design was used to identify change in balance, depressive symptoms, and global cognition. A mixed method approach was employed to evaluate the feasibility of a CT intervention among a cohort of cognitively impaired older adults. CT was delivered in a group 2 days/week over 10 weeks using an online brain exercise program, Posit Science Brain HQ (20 h). All participants completed a one-on-one data collection interview at baseline and post-program.

RESULTS

Participants ( = 20) were on average 80.5 years old and had mild to moderate cognitive impairment. Following the 10-week CT intervention, mean scores on 4 of the 5 balance measures improved among CT participants. Although none of the balance improvements reached significance, these findings are promising given the small sample size. Depressive symptoms significantly improved between baseline and 10 weeks ( = 0.021). Mean global cognition also improved across the study period, but neither of these improvements were statistically significant. Based on participant responses, the CT program was feasible for this population.

CONCLUSION

This study provides support for the feasibility of implementing a CT program among cognitively impaired older adults in an adult day setting. Our findings also add to emerging literature that CT may be a novel and innovative approach to fall prevention among older adults.

摘要

背景

新出现的文献表明,运动能力与认知能力存在关联。流行病学数据支持认知功能正常的老年人认知能力与跌倒之间存在负相关。少数干预研究发现,有规律的认知训练(CT)可改善该人群的运动能力,这表明CT可能是一种尚未充分探索的减少跌倒的方法。迄今为止,尚无研究考察CT对认知障碍者平衡能力的影响。本研究的目的是评估在认知障碍老年人中实施CT计划的可行性,并考察CT后平衡能力是否有潜在改善。

方法

采用单组重复测量设计来确定平衡能力、抑郁症状和整体认知的变化。采用混合方法评估CT干预在一组认知障碍老年人中的可行性。使用在线大脑训练程序Posit Science Brain HQ(20小时),每周2天,共10周,以小组形式进行CT训练。所有参与者在基线和训练后完成一对一的数据收集访谈。

结果

参与者(n = 20)平均年龄为80.5岁,有轻度至中度认知障碍。经过10周的CT干预,CT参与者在5项平衡测量中的4项平均得分有所提高。尽管平衡能力的改善均未达到显著水平,但鉴于样本量较小,这些发现很有前景。抑郁症状在基线和10周之间显著改善(p = 0.021)。整个研究期间平均整体认知也有所改善,但这些改善均无统计学意义。根据参与者的反馈,CT计划对该人群是可行的。

结论

本研究为在成人日间护理环境中对认知障碍老年人实施CT计划的可行性提供了支持。我们的研究结果也为新兴文献增添了内容,即CT可能是预防老年人跌倒的一种新颖且创新的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8362/5066075/24f57cc65546/fpubh-04-00219-g001.jpg

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