GRADIOR 对轻度认知障碍和轻度痴呆患者的神经心理康复效果：一项随机对照试验研究结果，治疗 4 个月和 12 个月后的结果。
The Effectiveness of GRADIOR: A Neuropsychological Rehabilitation Program for People with Mild Cognitive Impairment and Mild Dementia. Results of a Randomized Controlled Trial After 4 and 12 Months of Treatment.
机构信息
Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain.
Department of Research and Development, Iberico Institute for Research in Psychoscience (IBIP), INTRAS Foundation, Zamora, Spain.
出版信息
J Alzheimers Dis. 2022;86(2):711-727. doi: 10.3233/JAD-215350.
BACKGROUND
Computer-based cognitive training programs have been developed with promising results on the maintenance/improvement of cognitive performance in people with dementia.
OBJECTIVE
The objective was to evaluate the effectiveness of the cognitive rehabilitation program "GRADIOR" in people with mild cognitive impairment and mild dementia.
METHOD
This study was a single-blind multicenter randomized clinical trial. Participants were recruited from hospitals/day centers. The experimental group (EG) and control group (CG) received computer-based cognitive training (CCT) and routine daily care, respectively. Outcome measures at T0: baseline, T1: at 4 months, T2: at 12 months were compared within and between-groups.
RESULTS
Significant differences or important effect sizes were detected at the intragroup and intergroup level for most variables, observing a trend of improvement and/or maintenance at 4 months by Visual Reasoning of Cambridge Cognitive Examination (CAMCOG), Digit and Arithmetic of WAIS-III, Semantic Verbal Fluency, Mini-Mental State Exam (MMSE), Trail Making Test (TMT)-A-Mistakes and at 12 months by Visual Reasoning of CAMCOG, Digit Symbol of WAIS-III, TMT-B-mistakes, Visual Memory of Rivermead Behavioural Memory Test, Lexical Verbal Fluency-P, Yesavage's Geriatric Depression Scale (GDS), TMT-A-time scales whose objective was to evaluate some executive functions and/or the memory. The CG presented a worsening trend for most of the measures towards 12 months. There was also a significant interaction between "time and group" for MMSE (F = 8.971; p = 0.03; η2 = 0.019) and the GDS (F = 3.414; p = 0.04; η2 = 0.041), as well as small effect sizes for TMT-A-time (F = 1.641; p = 0.21; η2 = 0.021) and TMT-A-mistakes (F = 0.908; p = 0.41; η2 = 0.019).
CONCLUSION
CCT with GRADIOR has been proved to benefit cognitive functions (ISRCTN:15742788).
背景
基于计算机的认知训练计划已被开发出来，其在维持/改善痴呆患者的认知表现方面取得了有希望的结果。
目的
评估认知康复计划“GRADIOR”在轻度认知障碍和轻度痴呆患者中的有效性。
方法
这是一项单盲多中心随机临床试验。参与者从医院/日间中心招募。实验组（EG）和对照组（CG）分别接受基于计算机的认知训练（CCT）和常规日常护理。在组内和组间比较 T0（基线）、T1（4 个月）和 T2（12 个月）的结果测量。
结果
在大多数变量中，实验组和对照组在组内和组间均显示出显著差异或重要的效应量，在 4 个月时通过剑桥认知测验的视觉推理（CAMCOG）、WAIS-III 的数字和算术、语义流畅性、简易精神状态检查（MMSE）、连线测试（TMT）-A-错误以及在 12 个月时通过 CAMCOG 的视觉推理、WAIS-III 的数字符号、TMT-B-错误、Rivermead 行为记忆测试的视觉记忆、词汇流畅性-P、耶萨奇老年抑郁量表（GDS）、TMT-A-时间等方面观察到改善和/或维持的趋势，这些变量旨在评估某些执行功能和/或记忆。CG 在 12 个月时，大多数指标的趋势是恶化。MMSE（F=8.971;p=0.03;η2=0.019）和 GDS（F=3.414;p=0.04;η2=0.041）的“时间和组”之间存在显著交互作用，以及 TMT-A-时间（F=1.641;p=0.21;η2=0.021）和 TMT-A-错误（F=0.908;p=0.41;η2=0.019）的小效应量。
结论
GRADIOR 中的 CCT 已被证明对认知功能有益（ISRCTN:15742788）。
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