Wolinsky Fredric D, Jones Michael P, Dotson Megan M
Department of Health, Management and Policy, College of Public Health, The University of Iowa.
College of Nursing, The University of Iowa.
Innov Aging. 2020 Jul 31;4(4):igaa029. doi: 10.1093/geroni/igaa029. eCollection 2020.
Visual speed of processing training had clinically and statistically significant beneficial effects on health-related quality of life among 2,802 healthy community-dwelling adults aged 65-94 years at 2 and 5 years post-training in the Advanced Cognitive Training for Independent and Vital Elderly randomized controlled trial. We examined whether that effect would be found among older adults in assisted and independent living communities.
We conducted a two-arm, parallel randomized controlled trial stratified by assisted versus independent settings in 31 senior living communities and enrolled 351 adults aged 55-102 years. The targeted intervention dose was 10 hr at baseline with 4-hr boosters at 5 and 11 months. The intervention group received computerized visual speed of processing training, while the attention control group solved computerized crossword puzzles. The health-related quality of life outcomes were the Short-Form 36-item Health Survey's mental and physical component scores. Linear mixed-effect models were used.
Visual speed of processing, assisted living, and their interaction had no clinically or statistically significant effects on the physical component scores. However, visual speed of processing ( = .022), assisted living ( = .022), and their interaction ( = .007) had clinically and statistically significant effects on the mental component scores. The estimated marginal means revealed a small effect-sized positive 2.2 point visual speed of processing training effect in the independent living communities, but a clinically important harmful -4.2 point visual speed of processing training effect in the assisted living communities.
Given the medium-sized harmful effect of visual speed of processing training among those in the assisted living communities, caution is advised when using these two visual speed of processing training modalities in assisted living communities until further research verifies or refutes our findings and the underlying etiological pathways.
在“独立与活力老年人高级认知训练”随机对照试验中，对2802名年龄在65 - 94岁的健康社区居民进行视觉处理速度训练，在训练后2年和5年时，对与健康相关的生活质量产生了临床和统计学上的显著有益影响。我们研究了在辅助生活和独立生活社区的老年人中是否也会发现这种效果。
我们在31个老年生活社区进行了一项双臂平行随机对照试验，根据辅助生活与独立生活环境进行分层，纳入了351名年龄在55 - 102岁的成年人。目标干预剂量为基线时10小时，在5个月和11个月时进行4小时的强化训练。干预组接受计算机化视觉处理速度训练，而注意力控制组解决计算机化填字游戏。与健康相关的生活质量结果是简短36项健康调查的心理和身体成分得分。使用线性混合效应模型。
视觉处理速度、辅助生活及其交互作用对身体成分得分没有临床或统计学上的显著影响。然而，视觉处理速度（P = 0.022）、辅助生活（P = 0.022）及其交互作用（P = 0.007）对心理成分得分有临床和统计学上的显著影响。估计的边际均值显示，在独立生活社区中，视觉处理速度训练有一个效应量较小的正向2.2分的效果，但在辅助生活社区中有一个临床上重要的有害的 - 4.2分的视觉处理速度训练效果。
鉴于视觉处理速度训练在辅助生活社区中的人群中有中等程度的有害影响，在辅助生活社区使用这两种视觉处理速度训练方式时应谨慎，直到进一步的研究证实或反驳我们的发现以及潜在的病因途径。
