基于过程的多任务自适应认知训练在社区轻度认知障碍老年人中的可转移性和可持续性：一项随机对照试验。
Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial.
机构信息
Department of Geriatric Psychiatry, Suzhou Guangji Hospital, JiangSu, China.
School of Medicine, Huzhou University, Zhejiang, China.
出版信息
BMC Psychiatry. 2023 Jun 12;23(1):418. doi: 10.1186/s12888-023-04917-3.
BACKGROUND
Cognitive training shows promising effects for improving cognitive domains in individuals with mild cognitive impairment (MCI), including the crucial predictive factor of executive function (EF) for dementia prognosis. Few studies have paid sufficient emphasis on the training-induced effects of cognitive training programs, particularly with regards to targeting EF. A process-based multi-task adaptive cognitive training (P-bM-tACT) program targeting EF is required to examine direct, transfer, and sustainability effects in older adults with MCI.
OBJECTIVE
This study aimed to evaluate the direct effects of a P-bM-tACT program on EF, the transfer effects on untrained cognitive domains, and further explore the sustainability of training gains for older adults with MCI in the community.
METHODS
In a single-blind, randomized controlled trial, 92 participants with MCI were randomly assigned to either the intervention group, participating in a P-bM-tACT program (3 training sessions/week, 60 min/session for 10 weeks) or the wait-list control group, accepting a health education program on MCI (1 education session/ twice a week, 40-60 min/session for 10 weeks). The direct and transfer effects of the P-bM-tACT program were assessed at baseline, immediately after 10 weeks of training, and the 3-month follow-up. Repeated measures analysis of variance and a simple effect test were used to compare the direct and transfer effects over the 3-time points between the two groups.
RESULTS
The P-bM-tACT program yielded a greater benefit of direct and transfer effects in the intervention group participants than in the wait-list control group. Combined with the results of simple effect tests, the direct and transfer effects of participants in the intervention group significantly increased immediately after 10 weeks of training compared to the baseline (F = 14.702 ~ 62.905, p < 0.05), and these effects were maintained at the 3-month follow-up (F = 19.595 ~ 122.22, p < 0.05). Besides, the acceptability of the cognitive training program was established with a high adherence rate of 83.4%.
CONCLUSIONS
The P-bM-tACT program exerted positive direct and transfer effects on the improvement of cognitive function, and these effects were sustained for 3 months. The findings provided a viable and potential approach to improving cognitive function in older adults with MCI in the community.
TRIAL REGISTRATION
The trial was registered at Chinese Clinical Trials Registry on 09/01/2019 ( www.chictr.org.cn ; Number Registry: ChiCTR1900020585).
背景
认知训练在改善轻度认知障碍（MCI）个体的认知领域方面显示出有前景的效果，包括对痴呆症预后有重要预测作用的执行功能（EF）。很少有研究充分重视认知训练计划的训练诱导效应，特别是针对 EF。需要一种基于过程的多任务自适应认知训练（P-bM-tACT）计划来针对 EF，以检验认知功能正常的老年人的认知训练的直接、转移和可持续效果。
目的
本研究旨在评估针对 EF 的 P-bM-tACT 计划的直接影响、对未训练认知领域的转移影响，并进一步探讨认知功能正常的老年人在社区中认知训练效果的可持续性。
方法
在一项单盲、随机对照试验中，92 名 MCI 患者被随机分配到干预组或等待名单对照组。干预组参与者参加基于过程的多任务自适应认知训练（3 次/周，每次 60 分钟，持续 10 周），而等待名单对照组参与者接受关于 MCI 的健康教育计划（2 次/周，每次 40-60 分钟，持续 10 周）。在基线、10 周训练后和 3 个月随访时评估 P-bM-tACT 计划的直接和转移效果。采用重复测量方差分析和简单效应检验比较两组在 3 个时间点的直接和转移效果。
结果
与等待名单对照组相比，P-bM-tACT 计划对干预组参与者的直接和转移效果更有益。结合简单效应检验的结果，干预组参与者在 10 周训练后立即的直接和转移效果明显高于基线（F=14.70262.905，p<0.05），这些效果在 3 个月随访时仍然保持（F=19.595122.22，p<0.05）。此外，认知训练计划的可接受性很高，依从率为 83.4%。
结论
P-bM-tACT 计划对改善认知功能具有积极的直接和转移效果，并且这些效果可持续 3 个月。研究结果为改善社区认知功能正常的老年人的认知功能提供了一种可行且有潜力的方法。
试验注册
该试验于 2019 年 9 月 1 日在中国临床试验注册中心注册（www.chictr.org.cn；注册号：ChiCTR1900020585）。
Zotero 插件