Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, 16802, USA.
Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA.
Ageing Res Rev. 2019 Jul;52:32-52. doi: 10.1016/j.arr.2019.04.002. Epub 2019 Apr 17.
Behavioral interventions to improve cognitive function in older adults are widespread and can vary from theater classes to cognitive training programs. However, the effectiveness in maintaining different cognitive domains varies greatly both across and within intervention types. To date, no systematic reviews have synthesized findings across more than a few types of interventions (e.g., cognitive vs. exercise). This systematic review examined 11 types of behavioral interventions and the respective transfer to 19 cognitive domains, as well as transfer to everyday function. Study inclusion criteria were: peer-reviewed articles in English, samples of healthy adults aged 65 and older, and randomized controlled trials of behavioral interventions with reported cognitive outcomes. The 2017 search yielded 75 eligible articles comprising cognitive training, exercise training, combination interventions, cognitively-stimulating activities, and action video games. In general, process- (n = 26) and strategy-based (n = 16) cognitive training improved the trained domains but had weak transfer to non-trained domains. Aerobic training (n = 13) most consistently improved executive function, and strength/resistance (n = 8) and aerobic/resistance combination training (n = 6) most consistently improved cognitive inhibition and visual working memory. Combination interventions (n = 15 nonfactorial, n = 3 factorial) showed promise in improving verbal delayed recall and executive function. Few studies examined cognitively-stimulating activities or action video games, leaving inconclusive results about their effect on cognitive function. Few studies examined everyday function (n = 9), however, process- and strategy-based training demonstrated notable long-term transfer. Recommendations for future research and practice are highlighted.
行为干预措施广泛用于改善老年人的认知功能，干预措施形式多样，从戏剧课程到认知训练计划都有。然而，不同干预措施类型在维持不同认知领域的效果差异很大。迄今为止，还没有系统评价综合了几种干预措施（例如认知与运动）以上的研究结果。本系统评价考察了 11 种行为干预措施及其在 19 种认知领域的相应转移，以及对日常功能的转移。研究纳入标准为：以英语发表的同行评审文章，年龄在 65 岁及以上的健康成年人样本，以及报告认知结果的行为干预措施的随机对照试验。2017 年的检索结果包括 75 篇符合条件的文章，涉及认知训练、运动训练、联合干预、认知刺激活动和动作视频游戏。一般来说，基于过程（n=26）和策略（n=16）的认知训练可以提高训练领域的认知能力，但对非训练领域的认知能力的转移效果较弱。有氧运动（n=13）最能改善执行功能，力量/阻力训练（n=8）和有氧/阻力联合训练（n=6）最能改善认知抑制和视觉工作记忆。组合干预措施（n=15 个非析因，n=3 个析因）在提高言语延迟回忆和执行功能方面显示出了希望。很少有研究考察认知刺激活动或动作视频游戏，因此其对认知功能的影响尚无定论。很少有研究考察日常功能（n=9），但是基于过程和策略的训练显示出了显著的长期转移。本文还强调了对未来研究和实践的建议。
