Wöhl C, Richter S, Blättner B
Fachbereich Pflege und Gesundheit, Hochschule Fulda, Leipziger Straße 123, 36037, Fulda, Deutschland.
Z Gerontol Geriatr. 2018 Aug;51(6):656-665. doi: 10.1007/s00391-017-1330-3. Epub 2017 Oct 27.
The strengthening of cognitive resources is considered to be a preventive field of action within inpatient care. The aim is to evaluate the effectiveness of such interventions on cognitive performance in nursing home residents.
A systematic literature search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL and PsycINFO, as well as searches in trial registries and a screening of reference lists. The combined results were based on meta-analyses in random-effects models.
By including 10 primary studies, participating in cognitive activities showed a statistically significant greater cognitive performance compared to controls (standardized mean difference SMD = 0.46, 95% confidence interval CI 0.06-0.87, p = 0.0252). Subgroup analyses suggest a superiority of individually oriented cognitive activities with longer training periods and that especially nursing home residents with a better initial level of cognitive performance might benefit from cognitive interventions. However, due to the high risk of bias in the included studies and the presence of substantial heterogeneity, the results must be interpreted with caution.
The findings imply that cognitive activities implemented in nursing homes might be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify our results.
加强认知资源被认为是住院护理中的一个预防性行动领域。目的是评估此类干预措施对养老院居民认知表现的有效性。
在MEDLINE、Cochrane图书馆、EMBASE、CINAHL和PsycINFO数据库中进行了系统的文献检索，以及在试验注册库中进行检索并筛选参考文献列表。综合结果基于随机效应模型中的荟萃分析。
纳入10项主要研究后，与对照组相比，参与认知活动显示出在统计学上显著更高的认知表现（标准化均值差SMD = 0.46，95%置信区间CI 0.06 - 0.87，p = 0.0252）。亚组分析表明，具有较长训练期的个体化认知活动具有优势，并且特别是初始认知表现水平较好的养老院居民可能从认知干预中受益。然而，由于纳入研究中的偏倚风险较高且存在实质性异质性，结果必须谨慎解释。
研究结果表明，养老院实施的认知活动可能是有效的。考虑到证据质量较低，开展高质量研究对于验证我们的结果至关重要。
