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成人认知训练干预比较有效性(ICE-ACT)试验:原理、设计和基线特征。

Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT) Trial: Rationale, design, and baseline characteristics.

机构信息

Florida State University, Department of Psychology, Tallahassee, FL, United States.

Penn State University, Center for Healthy Aging, University Park, PA, United States.

出版信息

Contemp Clin Trials. 2019 Mar;78:76-87. doi: 10.1016/j.cct.2019.01.014. Epub 2019 Jan 31.

Abstract

Age-related perceptual and cognitive declines are associated with difficulties performing everyday tasks required to remain independent. Encouraging improvements in cognitive abilities have been shown for various short-term interventions but there is little evidence for direct impact on independence. This project compares the effect of broad and directed (narrow) technology-based training on basic perceptual and cognitive abilities in older adults and on the performance of simulated tasks of daily living including driving and fraud avoidance. Participants (N = 230, Mean age = 72) were randomly assigned to one of four training conditions: broad training using either (1) a web-based brain game suite, Brain HQ, or (2) a strategy video game, Rise of Nations, or to directed training for (3) Instrumental Activities of Daily Living (IADL) training using web-based programs for both driving and fraud avoidance training, or (4) to an active control condition of puzzle solving. Training took approximately 15-20 h for each intervention condition across four weeks. Before training began, participants received baseline ability tests of perception, attention, memory, cognition, and IADL, including a driving simulator test for hazard perception, and a financial fraud recognition test. They were tested again on these measures following training completion (post-test). A one-year follow-up from training completion is also scheduled. The baseline results support that randomization was successful across the intervention conditions. We discuss challenges and potential solutions for using technology-based interventions with older adults. We also discuss how the current trial addressed methodological limitations of previous intervention studies. TRIAL REGISTRATION NUMBER: NCT03141281.

摘要

与独立生活所需的日常任务相关的感知和认知能力下降与年龄有关。各种短期干预措施已被证明可以提高认知能力,但几乎没有证据表明它们对独立性有直接影响。本项目比较了广泛和有针对性(狭义)基于技术的训练对老年人基本感知和认知能力的影响,以及对模拟日常生活任务(包括驾驶和防范欺诈)的表现的影响。参与者(N=230,平均年龄=72)被随机分配到以下四种训练条件之一:使用(1)基于网络的大脑游戏套件 Brain HQ 或(2)策略视频游戏 Rise of Nations 进行广泛训练,或进行有针对性的训练,使用基于网络的程序进行驾驶和防范欺诈训练,或(3)进行基于网络的程序进行日常生活活动(IADL)训练,或(4)进行拼图解决的积极对照条件。每种干预条件的训练时间约为四周,共 15-20 小时。在开始训练之前,参与者接受了感知、注意力、记忆、认知和 IADL 的基线能力测试,包括驾驶模拟器的危险感知测试和金融欺诈识别测试。在完成训练后(后测)再次对这些指标进行测试。从完成训练到一年的随访也已安排。基线结果支持干预条件的随机分组是成功的。我们讨论了使用基于技术的干预措施与老年人相关的挑战和潜在解决方案。我们还讨论了当前试验如何解决以前干预研究的方法学限制。试验注册号:NCT03141281。

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