Yun Sunweon, Ryu Seang
Department of Nursing, Mokpo National University, Jeollanamdo, Republic of Korea.
Iran J Public Health. 2022 Jan;51(1):1-11. doi: 10.18502/ijph.v51i1.8286.
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.
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.
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).
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.
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。
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。
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)。
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。