Cassidy-Eagle Erin, Siebern Allison, Unti Lisa, Glassman Jill, O'Hara Ruth
a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.
c Fayetteville Veterans Affairs Medical Center , Fayetteville , North Carolina , USA.
Clin Gerontol. 2018 Mar-Apr;41(2):136-144. doi: 10.1080/07317115.2017.1384777. Epub 2017 Dec 8.
Improving the sleep of older adults with mild cognitive impairment (MCI) represents a first step in discovering whether interventions directed at modifying this risk factor also have the potential to alter the cognitive decline trajectory.
A six-session, adapted version of a cognitive behavioral therapy for insomnia (CBT-I) was administered to older adults (N = 28; 14 per group) with MCI across two residential facilities. Participants were randomly assigned to either the sleep intervention or an active control group and completed a neuropsychological battery at three time points (e.g., baseline-T1, post-intervention-T2, 4 month follow-up-T3).
Results showed a significant improvement in sleep and a change (p < .05) on a key measure of executive functioning sub task of inhibition (Condition 3 of D-KEF Color-Word Interference Test), a positive trend on the inhibition-switching task (p < .10; Condition 4 of D-KEF Color-Word Interference Test), an no change in a measure of verbal memory (HVLT-R Delayed Recall) compared with the active control group.
CBT-I is a nonpharmacological intervention that has the potential to cognitively benefit individuals with MCI suffering from comorbid insomnia.
Results suggest that a non-pharmacological intervention to improve sleep in older adults with MCI also improve cognitive functioning. Further exploration of the mechanisms underlying these improvements is warranted.
改善轻度认知障碍（MCI）老年人的睡眠是发现针对改变这一风险因素的干预措施是否也有可能改变认知衰退轨迹的第一步。
针对两个居住设施中的患有MCI的老年人（N = 28；每组14人）实施了一个六节的、改编版的失眠认知行为疗法（CBT-I）。参与者被随机分配到睡眠干预组或积极对照组，并在三个时间点（例如，基线-T1、干预后-T2、4个月随访-T3）完成一套神经心理学测试。
结果显示睡眠有显著改善，并且在执行功能抑制子任务的一项关键测量指标（D-KEF颜色-词语干扰测试的条件3）上有变化（p <.05），在抑制转换任务上有积极趋势（p <.10；D-KEF颜色-词语干扰测试的条件4），与积极对照组相比，言语记忆测量指标（HVLT-R延迟回忆）没有变化。
CBT-I是一种非药物干预措施，有可能使患有共病失眠的MCI个体在认知方面受益。
结果表明，一种改善MCI老年人睡眠的非药物干预措施也能改善认知功能。有必要进一步探索这些改善背后的机制。
