Department of Neurology, Columbia University Irving Medical Center, 710 West 168Th Street, New York, NY, 10032-3784, USA.
Curr Neurol Neurosci Rep. 2023 Sep;23(9):461-468. doi: 10.1007/s11910-023-01283-1. Epub 2023 Jul 10.
To critically review recent research in the development of non-pharmacological interventions to improve cognitive functioning in individuals with Alzheimer's disease (AD) or Parkinson's disease (PD).
Cognitive interventions can be grouped into three categories: cognitive stimulation (CS), cognitive training (CT), and cognitive rehabilitation (CR). CS confers temporary, nonspecific benefits and might slightly reduce dementia risk for neurologically healthy individuals. CT can improve discrete cognitive functions, but durability is limited and real-world utility is unclear. CR treatments are holistic and flexible and, therefore, most promising but are difficult to simulate and study under rigorous experimental conditions. Optimally effective CR is unlikely to be found in a single approach or treatment paradigm. Clinicians must be competent in a variety of interventions and select those interventions best tolerated by the patient and most relevant to their needs and goals. The progressive nature of neurodegenerative disease necessitates that treatment be consistent, open-ended in duration, and sufficiently dynamic to meet the patient's changing needs as their disease progresses.
批判性地回顾最近关于非药物干预措施的研究进展,以改善阿尔茨海默病(AD)或帕金森病(PD)患者的认知功能。
认知干预可以分为三类:认知刺激(CS)、认知训练(CT)和认知康复(CR)。CS 可带来暂时的、非特异性的益处,可能会略微降低神经认知健康个体的痴呆风险。CT 可以改善离散的认知功能,但效果持续时间有限,实际应用效果尚不清楚。CR 治疗是全面和灵活的,因此最有前途,但在严格的实验条件下很难模拟和研究。不太可能仅通过单一方法或治疗方案就能找到最有效的 CR。临床医生必须掌握各种干预措施,并选择那些患者最能耐受且最符合其需求和目标的干预措施。神经退行性疾病的渐进性特征要求治疗必须持续、无期限、足够动态,以满足患者随着疾病进展而不断变化的需求。