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轻度认知障碍(MCI)和轻度痴呆患者对“GRADIOR”计算机化认知训练项目依从性的决定因素

Determinants of Adherence to a "GRADIOR" Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia.

作者信息

Diaz Baquero Angie A, Perea Bartolomé María V, Toribio-Guzmán José Miguel, Martínez-Abad Fernando, Parra Vidales Esther, Bueno Aguado Yolanda, van der Roest Henriëtte G, Franco-Martín Manuel A

机构信息

Institute of Biomedical Research of Salamanca, University of Salamanca, 37001 Salamanca, Spain.

Department of Research and Development, INTRAS Foundation, 49001 Zamora, Spain.

出版信息

J Clin Med. 2022 Mar 19;11(6):1714. doi: 10.3390/jcm11061714.

Abstract

BACKGROUND

Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a "GRADIOR" computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia.

METHOD

This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group ( = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60-90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2-3 weekly sessions for 4 months with a duration of 30 min Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann-Whitney was used.

RESULTS

The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit -value of the model was 0.02.

CONCLUSIONS

good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent.

摘要

背景

基于计算机的程序已从社会心理方法实施,用于照顾痴呆症患者(PwD)。然而,几个因素可能决定老年痴呆症患者对这类治疗的依从性。本文的目的是确定社会人口统计学、认知、心理和身体健康方面的决定因素,这些因素有助于预测轻度认知障碍(MCI)和轻度痴呆症患者是否会坚持或不坚持“GRADIOR”计算机化认知训练(CCT)程序。

方法

本研究是一项随机临床试验(RCT)(ISRCTN:15742788)的一部分。然而,本研究将仅关注RCT中纳入的实验组(n = 43)。该组分为依从者(依从性:≥60%的疗程且治疗持续4个月)和非依从者。参与者年龄在60 - 90岁之间,被诊断为MCI和轻度痴呆症。我们从RCT的评估方案中选择了评估认知方面(记忆和执行功能)、心理和身体健康的测试。GRADIOR的CCT包括每周参加2 - 3次疗程,持续4个月,每次疗程持续30分钟。使用Phi和双列相关分析,进行多元逻辑回归分析以找到依从性模型,并使用U Mann - Whitney检验。

结果

依从性模型由韦氏成人智力量表(WAIS - III)的数字符号和算术以及词汇言语流畅性(LVF) - R测试组成。该模型具有90%的敏感性、50%的特异性和75%的精确度。模型的拟合优度 - 值为0.02。

结论

注意力、工作记忆(WM)、语音言语流畅性和认知灵活性方面良好的执行功能预示着一个人更有可能依从。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d32c/8955227/b05a6587341a/jcm-11-01714-g001.jpg

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