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构建并评估多领域注意力训练以改善轻度认知障碍老年人的警觉注意力、持续性注意力和视空间注意力:一项随机对照试验。

Construction and evaluation of multidomain attention training to improve alertness attention, sustained attention, and visual-spatial attention in older adults with mild cognitive impairment: A randomized controlled trial.

机构信息

Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, Republic of China.

School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.

出版信息

Int J Geriatr Psychiatry. 2020 May;35(5):537-546. doi: 10.1002/gps.5269. Epub 2020 Feb 14.

Abstract

OBJECTIVES

We aimed to analyze the effects of multidomain attention training on alertness, sustained attention, and visual-spatial attention in older adults with mild cognitive impairment (MCI).

DESIGN

The design used in this study was a two-arm, parallel group, double-blind randomized controlled trial.

SETTING AND PARTICIPANTS

The participants of the study were seventy-eight older adults with MCI (mean age: 79.5 ± 7.9 years) from retirement centers and community housing for the elderly.

INTERVENTION

The participants were randomly assigned to an experimental group (multidomain attention training, n = 39) or an active control group (n = 39). Both groups underwent training sessions for 45 minutes three times per week for 6 weeks (18 sessions in total).

MEASURES

The main efficacy indicator was alertness (Trail Making Test Part B), sustained attention (Digit Vigilance Test), and visual-spatial attention (Trail Making Test Part A). The secondary outcome indicators were other cognitive functions (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA] subscales). Measurements were obtained at pretest, posttest, and 3 and 6 months after training.

RESULTS

The results were analyzed by a generalized estimating equation (GEE), which indicated that attention outcomes (alertness, sustained attention, and visual-spatial attention) of the experimental group did not improve after training. However, the experimental group displayed a significant improvement in the attention, memory, and orientation of MMSE and MoCA subscales over a period of 6 months and also showed superior results compared with the control group.

CONCLUSIONS

Multidomain attention training demonstrated improved alertness and visual-spatial attention for posttest after 6 months. We also outline potential future advances in attention training for improving attention in older adults with MCI.

摘要

目的

我们旨在分析多领域注意力训练对轻度认知障碍(MCI)老年人警觉性、持续性注意力和视觉空间注意力的影响。

设计

本研究采用的设计为两臂、平行组、双盲随机对照试验。

设置和参与者

研究的参与者是来自退休中心和老年人社区住房的 78 名 MCI 老年人(平均年龄:79.5±7.9 岁)。

干预

参与者被随机分配到实验组(多领域注意力训练,n=39)或对照组(n=39)。两组均接受每周 3 次、每次 45 分钟的训练,共 6 周(18 次)。

测量

主要疗效指标为警觉性(连线测试 B 部分)、持续性注意力(数字警觉测试)和视觉空间注意力(连线测试 A 部分)。次要结果指标为其他认知功能(简易精神状态检查[MMSE]和蒙特利尔认知评估[MoCA]子量表)。在测试前、测试后以及训练后 3 个月和 6 个月进行测量。

结果

通过广义估计方程(GEE)进行分析,结果表明实验组注意力结果(警觉性、持续性注意力和视觉空间注意力)在训练后没有改善。然而,实验组在 MMSE 和 MoCA 子量表的注意力、记忆力和定向方面在 6 个月内显示出显著改善,并且与对照组相比表现出更好的结果。

结论

多领域注意力训练在 6 个月后表现出对测试后警觉性和视觉空间注意力的改善。我们还概述了注意力训练在改善 MCI 老年人注意力方面的潜在未来进展。

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