Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
Neuropsychol Rev. 2023 Jun;33(2):347-372. doi: 10.1007/s11065-022-09536-5. Epub 2022 May 11.
Prospective memory (PM), which enables one to remember to carry out delayed intentions, is crucial for everyday functioning. PM commonly deteriorates upon cognitive decline in older adults, but several studies have shown that PM in older adults can be improved by training. The current study aimed to summarise this evidence by conducting a qualitative systematic analysis and quantitative meta-analysis of the effects of PM training in older adults, for which systematic searches were conducted across seven databases (Cochrane Library, Embase, PubMed, PsycInfo, Web of Science, CINAHL and Scopus). Forty-eight studies were included in the qualitative analysis, and 43% of the assessed PM training interventions showed positive gains in enhancing PM. However, the methodological quality varied across the studies, with 41% of the non-randomised control trials (non-RCTs) rated as having either serious or critical risk of bias. Therefore, only 29 RCTs were included in the subsequent quantitative meta-analysis. We found a significant and moderate immediate efficacy (Hedges' g = 0.54) of PM training in enhancing PM performance in older adults, but no significant long-term efficacy (Hedges' g = 0.20). Two subgroup analyses also revealed a robust training efficacy across the study population (i.e., healthy and clinical population) and the number of training sessions (i.e., single session and programme-based). Overall, this study provided positive evidence to support PM training in older adults. Further studies are warranted to explore the mechanisms by which PM training exerts its effects, and better-quality RCTs are needed to provide more robust evidence supporting our findings.
前瞻性记忆（PM）使人能够记住延迟的意图，对日常功能至关重要。PM 在认知能力下降的老年人中通常会恶化，但有几项研究表明，通过训练可以改善老年人的 PM。本研究旨在通过对老年人 PM 训练效果进行定性系统分析和定量荟萃分析来总结这方面的证据，为此在七个数据库（Cochrane Library、Embase、PubMed、PsycInfo、Web of Science、CINAHL 和 Scopus）中进行了系统搜索。48 项研究纳入定性分析，评估的 PM 训练干预中有 43%显示出增强 PM 的积极收益。然而，研究的方法学质量存在差异，41%的非随机对照试验（非 RCT）被评为存在严重或关键的偏倚风险。因此，只有 29 项 RCT 被纳入随后的定量荟萃分析。我们发现 PM 训练在增强老年人 PM 表现方面具有显著且中等的即时效果（Hedges' g=0.54），但没有显著的长期效果（Hedges' g=0.20）。两项亚组分析还表明，在研究人群（即健康和临床人群）和训练次数（即单次和基于方案的训练）中都存在稳健的训练效果。总的来说，这项研究提供了支持老年人 PM 训练的积极证据。需要进一步的研究来探索 PM 训练发挥作用的机制，并且需要更好质量的 RCT 来提供更有力的证据支持我们的发现。
