Han Ji Won, Son Kyung Lak, Byun Hye Jin, Ko Ji Won, Kim Kayoung, Hong Jong Woo, Kim Tae Hyun, Kim Ki Woong
Department of Neuropsychiatry, Seoul National University Bundang Hospital, 166 Gumiro, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Korea.
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
Alzheimers Res Ther. 2017 Jun 6;9(1):39. doi: 10.1186/s13195-017-0264-8.
Spaced retrieval training (SRT) is a nonpharmacological intervention for mild cognitive impairment (MCI) and dementia that trains the learning and retention of target information by recalling it over increasingly long intervals. We recently developed the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program as a convenient, self-administered tablet-based SRT program. We also demonstrated the utility of USMART for improving memory in individuals with MCI through an open-label uncontrolled trial.
This study had an open-label, single-blind, randomized, controlled, two-period crossover design. Fifty patients with MCI were randomized into USMART-usual care and usual care-USMART treatment sequences. USMART was completed or usual care was provided biweekly over a 4-week treatment period with a 2-week washout period between treatment periods. Primary outcome measures included the Word List Memory Test, Word List Recall Test (WLRT), and Word List Recognition Test. Outcomes were measured at baseline, week 5, and week 11 by raters who were blinded to intervention type. An intention-to-treat analysis and linear mixed modeling were used.
Of 50 randomized participants, 41 completed the study (18% dropout rate). The USMART group had larger improvements in WLRT score (effect size = 0.49, p = 0.031) than the usual care group. There were no significant differences in other primary or secondary measures between the USMART and usual care groups. Moreover, no USMART-related adverse events were reported.
The 4-week USMART modestly improved information retrieval in older people with MCI, and was well accepted with minimal technical support.
ClinicalTrials.gov NCT01688128 . Registered 12 September 2012.
间隔检索训练（SRT）是一种针对轻度认知障碍（MCI）和痴呆症的非药物干预措施，通过在越来越长的时间间隔内回忆目标信息来训练学习和记忆。我们最近开发了基于无处不在的间隔检索的记忆促进与康复训练（USMART）计划，作为一种方便的、基于平板电脑的自我管理SRT计划。我们还通过一项开放标签的非对照试验证明了USMART对改善MCI患者记忆的效用。
本研究采用开放标签、单盲、随机、对照、两阶段交叉设计。50例MCI患者被随机分为USMART-常规护理组和常规护理-USMART治疗组。在为期4周的治疗期内，每两周完成一次USMART或提供常规护理，治疗期之间有2周的洗脱期。主要结局指标包括单词列表记忆测试、单词列表回忆测试（WLRT）和单词列表识别测试。由对干预类型不知情的评估者在基线、第5周和第11周测量结局。采用意向性分析和线性混合模型。
50名随机参与者中，41人完成了研究（脱落率为18%）。USMART组的WLRT评分改善幅度大于常规护理组（效应量=0.49，p=0.031）。USMART组和常规护理组在其他主要或次要指标上无显著差异。此外，未报告与USMART相关的不良事件。
为期4周的USMART适度改善了老年MCI患者的信息检索能力，且在最少技术支持下被广泛接受。
ClinicalTrials.gov NCT01688128。2012年9月12日注册。
