Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Am Geriatr Soc. 2018 Apr;66(4):664-670. doi: 10.1111/jgs.15196. Epub 2018 Jan 18.
To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia.
Single-blind randomized controlled trial with 3- and 9-month follow-up.
Adult day care centers in Helsinki, Finland.
Older individuals with mild to moderate dementia living at home and attending adult day care twice a week (N = 147; mean age 83, 72% female, 63% at mild stage of dementia).
A systematic 12-week training program focused on subskills of executive function: attention, working memory, cognitive flexibility, and planning. The intervention group (n = 76) underwent cognitive training twice a week for 45 minutes, and the control group (n = 71) attended day care as usual.
Primary outcomes were the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) for global cognition and the 15-dimensional instrument (15D) for HRQoL. The outcomes were measured at baseline and 3 and 9 months.
Both groups deteriorated in global cognition and HRQoL during follow-up, and there were no differences between the two groups in change on the ADAS-Cog (P = .43) or 15D (P = .61) over time (adjusted for age and sex). At 3 months, changes were 0.8 (95% confidence interval (CI) = -0.2-1.8) for the intervention group and 1.7 (95% CI = 0.6-2.7) for the control group on the ADAS-Cog and -0.040 (95% CI = -0.058 to -0.021) for the intervention group and -0.037 (95% CI = -0.056 to -0.018) for the control group on the 15D.
Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.
评估认知训练对社区居住的轻度至中度痴呆患者认知功能和健康相关生活质量（HRQoL）的影响。
3 个月和 9 个月随访的单盲随机对照试验。
芬兰赫尔辛基的成人日间护理中心。
居住在家中且每周两次参加成人日间护理的轻度至中度痴呆老年人（N=147；平均年龄 83 岁，72%为女性，63%处于轻度痴呆阶段）。
一项针对执行功能子技能（注意力、工作记忆、认知灵活性和计划）的系统 12 周训练计划。干预组（n=76）每周接受两次认知训练，每次 45 分钟，对照组（n=71）照常参加日间护理。
主要结局是用于评估总体认知的阿尔茨海默病评估量表认知子量表（ADAS-Cog）和用于评估 HRQoL 的 15 维量表（15D）。在基线和 3 个月及 9 个月时进行测量。
两组患者在随访期间的总体认知和 HRQoL 均有所下降，且两组患者在 ADAS-Cog（P=0.43）或 15D（P=0.61）上的变化无差异（调整年龄和性别后）。在 3 个月时，干预组 ADAS-Cog 的变化为 0.8（95%置信区间（CI）为-0.2-1.8），对照组为 1.7（95% CI 为 0.6-2.7）；干预组 15D 的变化为-0.040（95% CI 为-0.058 至-0.021），对照组为-0.037（95% CI 为-0.056 至-0.018）。
针对社区居住的轻度至中度痴呆患者，系统性认知训练对总体认知或 HRQoL 没有影响。
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