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基于认知的干预措施对老年人的影响:一项系统评价与荟萃分析

The Effects of Cognitive-Based Interventions in Older Adults: A Systematic Review and Meta-Analysis.

作者信息

Yun Sunweon, Ryu Seang

机构信息

Department of Nursing, Mokpo National University, Jeollanamdo, Republic of Korea.

出版信息

Iran J Public Health. 2022 Jan;51(1):1-11. doi: 10.18502/ijph.v51i1.8286.

Abstract

BACKGROUND

Cognitive-based intervention is divided into three types: Cognitive Stimulation (CS), Cognitive Training (CT), and Cognitive Rehabilitation (CR). This study was conducted to identify systematically the effects of cognitive-based interventions in randomized controlled trials (RCTs) applied to older adults in the following three groups: cognitively healthy, mild cognitive impairment (MCI), and dementia.

METHODS

This search was carried out using the Ovid-MEDLINE, EMBASE, Cochrane library, CINAHL, ProQuest, and Korea databases. The effectiveness of the intervention was verified using the CMA 2.0 program.

RESULTS

A total of 54 RCTs were included in systematic reviews and 38 studies were analyzed by meta-analysis. Meta-analysis showed that cognitive-based interventions were effective in improving the cognitive function (SMD=0.39, 95% CI=0.32-0.44) of older adults. The subgroup analysis of cognitive function revealed that CT was the most effective in the cognitively healthy (SMD=0.40, 95% CI=0.33-0.46) and the MCI (SMD=0.45, 95% CI=0.27-0.63) groups, and CS was the most effective in the dementia group (SMD=0.57, 95% CI=0.43-0.70).

CONCLUSION

In order to improve the cognitive function of older adults in each group, the most effective intervention type needs to be considered first. Evidence on the appropriate type of Cognitive-based intervention will be helpful in nursing practice.

摘要

背景

基于认知的干预分为三种类型:认知刺激(CS)、认知训练(CT)和认知康复(CR)。本研究旨在系统地确定在随机对照试验(RCT)中应用于以下三组老年人的基于认知的干预措施的效果:认知健康、轻度认知障碍(MCI)和痴呆症。

方法

使用Ovid-MEDLINE、EMBASE、Cochrane图书馆、CINAHL、ProQuest和韩国数据库进行检索。使用CMA 2.0程序验证干预措施的有效性。

结果

系统评价共纳入54项RCT,38项研究进行了荟萃分析。荟萃分析表明,基于认知的干预措施在改善老年人认知功能方面有效(标准化均数差[SMD]=0.39,95%置信区间[CI]=0.32-0.44)。认知功能亚组分析显示,CT在认知健康组(SMD=0.40,95%CI=0.33-0.46)和MCI组(SMD=0.45,95%CI=0.27-0.63)中最有效,CS在痴呆症组中最有效(SMD=0.57,95%CI=0.43-0.70)。

结论

为改善每组老年人的认知功能,首先需要考虑最有效的干预类型。关于适当类型的基于认知的干预措施的证据将有助于护理实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc50/8837877/c954ff23fd0f/IJPH-51-1-g001.jpg

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