Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Rossier School of Education, University of Southern California, Los Angeles, CA, USA.
J Alzheimers Dis. 2020;76(1):399-421. doi: 10.3233/JAD-200261.
Meta-analysis examining the efficacy of cognitive interventions on neuropsychological outcomes have suggested interventions that focus on memory may actually provide greater benefit against the cognitive declines associated with mild cognitive impairment (MCI). However, it remains unclear if memory-based training would be more effective at addressing the cognitive deficits associated with MCI than multidomain forms of intervention.
A meta-analytic review and subgroup analysis was conducted to examine the effects of cognitive training in individuals diagnosed with MCI and to compare the efficacy of memory-based training with multidomain interventions.
A total of 32 randomized controlled trials met inclusion criteria for the meta-analysis, which included 9 studies on memory-focused training and 17 studies on multidomain interventions.
We found significant, large effects for memory-focused training (Hedges' g observed = 0.947; 95% CI [-1.668, 3.562]; Z = 2.517; p = 0.012) and significant, moderate effects for multidomain interventions (Hedges' g observed = 0.420; 95% CI [-0.4491, 1.2891]; Z = 3.525; p < 0.001). A subgroup analysis found significant point estimates for memory-based forms of training and multidomain interventions, with memory-based forms of content yielding significantly greater summary effects than multidomain interventions (SMD Z = 2.162; p = 0.031, two-tailed; all outcomes). There was no difference between effect sizes when comparing outcomes limited to its respective domain.
Overall, these findings suggest that, while both interventions were beneficial, treatment interventions that were strictly memory-based were more effective at improving cognition in individuals diagnosed with MCI than interventions that targeted multiple cognitive domains.
对认知干预对神经心理学结果的疗效进行的荟萃分析表明，专注于记忆的干预实际上可能会提供更大的益处，以对抗与轻度认知障碍（MCI）相关的认知下降。然而，目前尚不清楚基于记忆的训练是否比多领域干预更能有效解决与 MCI 相关的认知缺陷。
进行荟萃分析综述和亚组分析，以检查认知训练对 MCI 患者的影响，并比较基于记忆的训练与多领域干预的疗效。
共有 32 项随机对照试验符合荟萃分析的纳入标准，其中包括 9 项针对记忆聚焦训练的研究和 17 项针对多领域干预的研究。
我们发现，基于记忆的训练具有显著的、大的效果（Hedges' g 观察值=0.947；95%置信区间[-1.668，3.562]；Z=2.517；p=0.012），多领域干预也具有显著的、中等的效果（Hedges' g 观察值=0.420；95%置信区间[-0.4491，1.2891]；Z=3.525；p<0.001）。亚组分析发现，基于记忆的训练形式和多领域干预的显著点估计值，基于记忆的内容形式产生的汇总效果明显大于多领域干预（SMD Z=2.162；p=0.031，双侧；所有结果）。当比较仅限于各自领域的结果时，两种干预效果之间没有差异。
总的来说，这些发现表明，虽然两种干预都有益，但严格基于记忆的治疗干预在改善 MCI 患者认知方面比针对多个认知领域的干预更有效。
