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执行注意训练的构建与评估对改善轻度认知障碍老年人的选择性注意、集中注意和分散注意的效果:一项随机对照试验。

The Construction and Evaluation of Executive Attention Training to Improve Selective Attention, Focused Attention, and Divided Attention for Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial.

机构信息

School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.

Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Am J Geriatr Psychiatry. 2019 Nov;27(11):1257-1267. doi: 10.1016/j.jagp.2019.05.017. Epub 2019 May 29.

Abstract

OBJECTIVES

To examine the immediate and long-term effects of executive attention training on selective attention, focused attention, and divided attention in older adults with mild cognitive impairment.

METHODS

A double-blind, multisite randomized controlled trial at five sites. Seventy participants (mean age: 78.19 ± 7.22 years) were assigned to an experimental group (executive attention training, n = 35) or an active control group (n = 35). The training duration was the same for both groups (45 minutes per session, 3 times per week, 18 sessions in total). Primary outcome measure was selective attention (Digit Span Task). Secondary outcome measures included focused attention (Stroop Color Word Test) and divided attention (Trail-Making Test Part B). Data were collected at pretest, post-test, 3-month follow-up, and 6-month follow-up.

RESULTS

In GEE analysis, findings indicated a significant improvement in selective attention at post-test, whereas divided attention showed significant reducing omission error at 3-month follow-up. There was no significant effect of group in focused attention associated with the executive attention training compared with active control group.

CONCLUSION

The executive attention training significantly improved selective attention and divided attention performance. Future studies should identify transfer effects of attention training, and that can employ early screening to provide integrated attention training, and decrease its relevant risks on competency in performing daily activities, such as falling and driving.

摘要

目的

研究执行注意训练对轻度认知障碍老年人选择性注意、集中注意和分散注意的即时和长期影响。

方法

在五个地点进行了一项双盲、多中心随机对照试验。70 名参与者(平均年龄:78.19 ± 7.22 岁)被分配到实验组(执行注意训练,n=35)或对照组(n=35)。两组的训练时间相同(每次 45 分钟,每周 3 次,共 18 次)。主要结局测量指标是选择性注意(数字跨度任务)。次要结局测量指标包括集中注意(Stroop 颜色词测试)和分散注意(Trail-Making 测试 B 部分)。数据在预测试、后测试、3 个月随访和 6 个月随访时收集。

结果

在 GEE 分析中,研究结果表明选择性注意在后测时显著改善,而分散注意在 3 个月随访时显著减少了遗漏错误。与对照组相比,实验组在集中注意力方面没有显著的执行注意训练效果。

结论

执行注意训练显著提高了选择性注意和分散注意的表现。未来的研究应该确定注意训练的转移效应,并且可以采用早期筛查来提供综合的注意训练,减少其对执行日常活动(如跌倒和驾驶)能力的相关风险。

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