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两种计算机化认知训练程序Bettercog和COMCOG对老年MCI和轻度痴呆患者影响的比较:一项单盲随机对照研究。

A comparison of the effects between 2 computerized cognitive training programs, Bettercog and COMCOG, on elderly patients with MCI and mild dementia: A single-blind randomized controlled study.

作者信息

Lee Goo Joo, Bang Heui Je, Lee Kyoung Moo, Kong Hyun Ho, Seo Hyeun Suk, Oh Minwoo, Bang Miyeon

机构信息

Department of Rehabilitation Medicine, Chungbuk National University Hospital.

Chungbuk Regional Cardiocerebrovascular Center, Cheongju-si, Republic of Korea.

出版信息

Medicine (Baltimore). 2018 Nov;97(45):e13007. doi: 10.1097/MD.0000000000013007.

Abstract

BACKGROUND

A computerized cognitive rehabilitation program can be used to treat patients with mild cognitive impairment or dementia. We developed a new computerized cognitive rehabilitation program (Bettercog) that contained various treatment programs for cognitive training for mild cognitive impairment or dementia. This study was conducted to compare the clinical efficacy of Bettercog and computer-assisted cognitive rehabilitation (COMCOG) that has had clinical efficacy previously proven in patients with mild cognitive impairment or dementia.

METHODS

Randomized, single-blind comparison pilot study of 20 elderly patients with cognitive decline-eight men and 12 women-with an average age of 74.3 years. Bettercog trains not only memory and attention but also orientation, calculation, executive function, language, comprehension, and spatiotemporal abilities. To retain subjects' interest, pictures, animations, and game elements were introduced. The subjects were divided into COMCOG and Bettercog groups by random assignment and underwent 12 sessions of a computerized cognitive rehabilitation program for three weeks. In a separate space, an independent clinical psychologist conducted the Seoul Neuropsychological Screening Battery 2nd edition (SNSB-II), Korean Mini-Mental State Examination (K-MMSE), Clinical Dementia Rating (CDR), and the Korean version of the Modified Barthel Index (K-MBI) before and after treatment.

RESULTS

There was no significant difference between the two groups in baseline age, sex, illiteracy, years of education, and scores on the K-MMSE, CDR, SNSB-II, and K-MBI. In the posttreatment cognitive assessment, the K-MMSE scores of patients treated with Bettercog improved from 19.2 ± 3.9 to 21.3 ± 4.0 (P = .005). In the memory domain of the SNSB-II, the percentile score improved from 15.3 ± 24.5 to 24.2 ± 30.7 (P = .026). However, there was no statistically significant difference in the final K-MMSE, CDR, and SNSB-II scores between the two treatment groups. In both groups, K-MBI scores improved statistically significantly after treatment.

CONCLUSIONS

Through this preliminary study, we verified that the newly developed computerized cognitive rehabilitation program is effective in improving cognitive function. However, 12 sessions are not enough to administer a variety of cognitive rehabilitation content to patients. It is, therefore, necessary to conduct a large-scale study using a computerized cognitive rehabilitation program that has various cognitive content.

摘要

背景

计算机化认知康复程序可用于治疗轻度认知障碍或痴呆患者。我们开发了一种新的计算机化认知康复程序(Bettercog),其中包含针对轻度认知障碍或痴呆的各种认知训练治疗程序。本研究旨在比较Bettercog与计算机辅助认知康复(COMCOG)的临床疗效,COMCOG先前已在轻度认知障碍或痴呆患者中证明具有临床疗效。

方法

对20名认知功能下降的老年患者进行随机、单盲比较性试点研究,其中男性8名,女性12名,平均年龄74.3岁。Bettercog不仅训练记忆和注意力,还训练定向、计算、执行功能、语言、理解和时空能力。为了保持受试者的兴趣,引入了图片、动画和游戏元素。通过随机分配将受试者分为COMCOG组和Bettercog组,并进行为期三周的12节计算机化认知康复程序。在一个单独的空间里,一名独立的临床心理学家在治疗前后进行了首尔神经心理筛查量表第2版(SNSB-II)、韩国简易精神状态检查表(K-MMSE)、临床痴呆评定量表(CDR)和韩国版改良巴氏指数(K-MBI)评估。

结果

两组在基线年龄、性别、文盲率、受教育年限以及K-MMSE、CDR、SNSB-II和K-MBI评分方面无显著差异。在治疗后的认知评估中,接受Bettercog治疗的患者的K-MMSE评分从19.2±3.9提高到21.3±4.0(P = 0.005)。在SNSB-II的记忆领域中,但两组在最终K-MMSE、CDR和SNSB-II评分上无统计学显著差异。在两组中,治疗后K-MBI评分均有统计学显著提高。

结论

通过这项初步研究,我们验证了新开发的计算机化认知康复程序在改善认知功能方面是有效的。然而,12节课程不足以向患者提供各种认知康复内容。因此,有必要使用具有各种认知内容的计算机化认知康复程序进行大规模研究。

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