School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Nursing, En Chu Kong Hospital, Taipei, Taiwan.
Int J Nurs Stud. 2018 Feb;78:44-51. doi: 10.1016/j.ijnurstu.2017.08.005. Epub 2017 Aug 20.
A better understanding of people with cognitive disorders improves performance on memory tasks through memory-focused interventions are needed.
The purpose of this study was to assess the effect of memoryfocused interventions on cognitive disorders through a meta-analysis.
Systematic review and meta-analysis.
The online electronic databases PubMed, the Cochrane Library, Ovid-Medline, CINHAL, PsycINFO, Ageline, and Embase (up to May 2017) were used in this study. No language restriction was applied to the search.
Objective memory (learning and memory function, immediate recall, delayed recall, and recognition) was the primary indicator and subjective memory performance, global cognitive function, and depression were the secondary indicators. The Hedges' g of change, subgroup analyses, and meta-regression were analyzed on the basis of the characteristics of people with cognitive disorders.
A total of 27 studies (2177 participants, mean age=75.80) reporting RCTs were included in the meta-analysis. The results indicated a medium-to-large effect of memory-focused interventions on learning and memory function (Hedges' g=0.62) and subjective memory performance (Hedges' g=0.67), a small-to-medium effect on delayed recall and depression, and a small effect on immediate recall and global cognitive function (all p<0.05) compared with the control. Subgroup analysis and meta-regression indicated that the effects on learning and memory function were more profound in the format of memory training, individual training, shorter treatment duration, and more than eight treatment sessions, and the effect size indicated the MMSE score was the most crucial indicator (β=-0.06, p=0.04).
This is first comprehensive meta-analysis of special memory domains in people with cognitive disorders. The results revealed that memory-focused interventions effectively improved memory-related performance in people with cognitive disorders. An appropriately designed intervention can effectively improve memory function, reduce disability progression, and improve mood state in people with cognitive disorders. Additional randomized controlled trials including measures of recognition, global cognitive function, and depression should be conducted and analyzed.
为了提高人们在记忆任务中的表现，需要更好地了解认知障碍患者，并进行以记忆为重点的干预。
本研究旨在通过荟萃分析评估以记忆为重点的干预对认知障碍的影响。
系统评价和荟萃分析。
本研究检索了在线电子数据库 PubMed、Cochrane 图书馆、Ovid-Medline、CINHAL、PsycINFO、Ageline 和 Embase（截至 2017 年 5 月），未对检索语言进行限制。
客观记忆（学习和记忆功能、即刻回忆、延迟回忆和识别）是主要指标，主观记忆表现、整体认知功能和抑郁是次要指标。根据认知障碍患者的特点，进行了 Hedges g 变化的亚组分析和荟萃回归分析。
共纳入 27 项研究（2177 名参与者，平均年龄=75.80）的随机对照试验进行荟萃分析。结果表明，与对照组相比，以记忆为重点的干预对学习和记忆功能（Hedges g=0.62）和主观记忆表现（Hedges g=0.67）具有中等至较大的影响，对延迟回忆和抑郁具有较小至中等的影响，对即刻回忆和整体认知功能具有较小的影响（均 P<0.05）。亚组分析和荟萃回归分析表明，在记忆训练形式、个体训练、较短的治疗持续时间和超过 8 个治疗疗程中，对学习和记忆功能的影响更为显著，且 MMSE 评分是最重要的指标（β=-0.06，P=0.04）。
这是首个关于认知障碍患者特定记忆领域的综合荟萃分析。结果表明，以记忆为重点的干预措施可有效改善认知障碍患者的记忆相关表现。适当设计的干预措施可以有效改善认知障碍患者的记忆功能，减缓残疾进展，改善情绪状态。应开展并分析更多包含识别、整体认知功能和抑郁的随机对照试验。
