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多组分干预对痴呆风险老年人认知训练和生活方式指导的效果:一项随机对照试验。

Effects of a Multicomponent Intervention With Cognitive Training and Lifestyle Guidance for Older Adults at Risk of Dementia: A Randomized Controlled Trial.

机构信息

School of Public Health, Fudan University, Shanghai, China.

NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.

出版信息

J Clin Psychiatry. 2024 May 13;85(2):23m15112. doi: 10.4088/JCP.23m15112.

Abstract

This study examined the effects of a multicomponent intervention program on cognitive function in community-dwelling older adults with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). This was a 2-arm, randomized controlled trial in which a multicomponent intervention was applied. Participants were recruited from June 2020 to August 2020, randomization and intervention began in August 2020, and the entire program ended in January 2021. It included cognitive training (mnemonic strategy training) and lifestyle guidance (diet, sleep, and exercise guidance) for 7 weeks. A total of 123 Chinese community-dwelling older adults experiencing MCI or SCD were randomly divided into a multicomponent intervention group (n = 62) and a health education group (n = 61). The global cognitive function was measured using the Mini-Mental State Examination (MMSE). The cognitive domains outcomes included memory functions measured using the immediate and delayed tests of the Auditory Verbal Learning Test (AVLT) and Logical Memory Test (LMT), and executive function and attention measured using the Digital Symbol Substitution Test (DSST) and Digit Span Test (DST). Data were collected at baseline and postintervention. For cognitive outcome, the results of linear mixed-effect model showed significant time × group effects in the MMSE (Cohen =0.63 [95% CI, 0.27 to 1.00], = 10.25, = .002). This study found significant time × group effects in AVLT-immediate (Cohen = 0.47 [95% CI, 0.11 to 0.83], = 8.18, = .005), AVLT delayed (Cohen = 0.45 [95% CI, 0.10 to 0.81], = 4.59, = .034), LMT-delayed (Cohen = 0.71 [95% CI, 0.34 to 1.07], = 4.59, = .034), DSST (Cohen = 0.27 [95% CI, -0.08 to 0.63], = 4.83, = .030), and DST (Cohen =0.69 [95% CI, 0.33 to 1.05], = 8.58, = .004). The results support the feasibility and effectiveness of the multicomponent intervention program in improving cognitive function in community dwelling older adults at risk of dementia. The high adherence of this program shows its potential for promotion in the community and supports a larger and longer trial. Chinese Clinical Trial Registry (ChiCTR2200061420).

摘要

本研究旨在探讨多组分干预方案对社区居住的轻度认知障碍(MCI)和主观认知下降(SCD)老年患者认知功能的影响。这是一项 2 臂随机对照试验,采用多组分干预措施。参与者于 2020 年 6 月至 8 月招募,随机化和干预于 2020 年 8 月开始,整个项目于 2021 年 1 月结束。它包括认知训练(记忆策略训练)和生活方式指导(饮食、睡眠和运动指导),为期 7 周。共有 123 名来自中国社区的 MCI 或 SCD 老年患者被随机分为多组分干预组(n = 62)和健康教育组(n = 61)。使用简易精神状态检查(MMSE)测量整体认知功能。认知域的结果包括使用听觉词语学习测试(AVLT)即时和延迟测试测量的记忆功能和逻辑记忆测试(LMT),以及使用数字符号替代测试(DSST)和数字跨度测试(DST)测量的执行功能和注意力。数据在基线和干预后收集。对于认知结果,线性混合效应模型的结果显示,在 MMSE 中存在显著的时间×组效应(Cohen = 0.63 [95% CI,0.27 至 1.00], = 10.25, =.002)。本研究发现,在 AVLT-即时(Cohen = 0.47 [95% CI,0.11 至 0.83], = 8.18, =.005)、AVLT-延迟(Cohen = 0.45 [95% CI,0.10 至 0.81], = 4.59, =.034)、LMT-延迟(Cohen = 0.71 [95% CI,0.34 至 1.07], = 4.59, =.034)、DSST(Cohen = 0.27 [95% CI,-0.08 至 0.63], = 4.83, =.030)和 DST(Cohen = 0.69 [95% CI,0.33 至 1.05], = 8.58, =.004)中存在显著的时间×组效应。结果支持多组分干预方案在改善痴呆风险的社区居住老年人认知功能方面的可行性和有效性。该方案的高依从性表明其在社区推广的潜力,并支持更大规模和更长时间的试验。中国临床试验注册中心(ChiCTR2200061420)。

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