Reynolds Gretchen O, Willment Kim, Gale Seth A
Department of Neurology, Brigham and Women's Hospital, Boston, Mass.
Department of Neurology, Brigham and Women's Hospital, Boston, Mass.
Am J Med. 2021 Apr;134(4):444-455. doi: 10.1016/j.amjmed.2020.10.041. Epub 2020 Dec 29.
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
由于缺乏针对轻度认知障碍和痴呆症的疾病修饰性药物治疗方法,临床和研究对这些疾病的非药物干预的关注日益增加。许多治疗方法,如正念和认知训练,旨在减轻或延缓认知衰退,特别是在疾病早期阶段,同时还能为情绪和生活质量带来潜在益处。在本综述中,我们强调正念和认知训练在改善轻度认知障碍患者认知和情绪方面的潜力。新出现的研究表明,这些方法在该人群中是可行且安全的,有初步证据表明对认知(注意力、心理运动功能、记忆、执行功能)、抑郁和焦虑等方面有积极影响,尽管一些研究结果尚不清楚或受方法学缺陷的限制。即便如此,正念和认知训练仍应作为目前治疗轻度认知障碍成人患者的方法,即使还需要更多研究来阐明治疗效果以及与剂量、机制、治疗效果的转移和持久性相关的问题。