Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China.
Neuropsychol Rev. 2022 Jun;32(2):247-273. doi: 10.1007/s11065-021-09486-4. Epub 2021 Apr 24.
Cognitive intervention includes cognitive stimulation, cognitive training, and cognitive rehabilitation. This systematic review was performed to re-assess the efficacy of cognitive intervention for the patients with Alzheimer's disease (AD). Twenty studies (2012 participants) were eventually included. For global cognitive function, the combined mean difference (MD) in eight studies was 1.67 (95% Confidence Interval: 0.45, 2.89, p = 0.007; Q = 33.28, df = 8, p < 0.0001, τ = 2.17, I = 76%) for the short term. The pooled standardized mean difference (SMD) of six RCTs was 1.61 (95% Confidence Interval: 0.65, 2.56, p = 0.0009; Q = 127.66, df = 6, p < 0.00001, τ = 1.56, I = 95%) for the medium term. The pooled SMD of seven studies was 0.79 (95% Confidence Interval: 0.33, 1.25, p = 0.0008; Q = 35.10, df = 7, p < 0.0001, τ = 0.33, I = 80%) for the long term. For depression, the pooled SMD of two trials was -0.48 (95% Confidence Interval: -0.71, -0.24; p < 0.0001, I = 4%) for the short term. Cognitive training may show obvious improvements in global cognitive function whether after short, medium, or long-term interventions and in depression after short term intervention. However, the positive effect of the intervention on general cognitive function or depression did not seem to persist after intervention ended. There is still a lack of reliable and consistent conclusions relevant to the effect of cognitive stimulation and cognitive rehabilitation on observed outcomes, cognitive training for memory or other non-cognitive outcomes. PROSPERO registration number: CRD42019121768.
认知干预包括认知刺激、认知训练和认知康复。本系统评价旨在重新评估认知干预对阿尔茨海默病（AD）患者的疗效。最终纳入 20 项研究（2012 名参与者）。对于整体认知功能，8 项研究的合并均数差值（MD）为 1.67（95%置信区间：0.45，2.89，p=0.007；Q=33.28，df=8，p<0.0001，τ=2.17，I=76%），短期效果明显。6 项 RCT 的合并标准化均数差值（SMD）为 1.61（95%置信区间：0.65，2.56，p=0.0009；Q=127.66，df=6，p<0.00001，τ=1.56，I=95%），中期效果明显。7 项研究的合并 SMD 为 0.79（95%置信区间：0.33，1.25，p=0.0008；Q=35.10，df=7，p<0.0001，τ=0.33，I=80%），长期效果明显。对于抑郁，2 项试验的合并 SMD 为-0.48（95%置信区间：-0.71，-0.24；p<0.0001，I=4%），短期效果明显。认知训练无论在短期、中期还是长期干预后，对整体认知功能，以及短期干预后对抑郁，均显示出明显的改善。然而，干预对整体认知功能或抑郁的积极作用在干预结束后似乎并未持续。对于认知刺激和认知康复对观察结果的影响，以及记忆或其他非认知结果的认知训练，仍缺乏可靠和一致的结论。PROSPERO 注册号：CRD42019121768。
