Pike Kerryn E, Li Lily, Naismith Sharon L, Bahar-Fuchs Alex, Lee Alessandra, Mehrani Inga, Bentvelzen Adam, Lautenschlager Nicola T, O'Connell Megan E, Blackberry Irene, Mowszowski Loren
School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Australia.
Neuropsychol Rev. 2024 Nov 6. doi: 10.1007/s11065-024-09650-6.
Despite compelling evidence that cognitive interventions for older adults improve cognition, mood, and everyday function, few are implemented in clinical or community practice. This scoping review aims to understand the implementation frameworks and methods used and their contribution to implementation success of cognitive interventions for older adults. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR), and searched CINAHL, EMBASE, MEDLINE, and PSYCINFO databases, using terms related to cognitive interventions, implementation, and older adults. This resulted in 5002 studies, of which 29 were included following an iterative process. Most studies reported on implementation of cognitive stimulation for people with dementia. Only four studies used formal implementation frameworks, with three using RE-AIM, and one a process evaluation using complexity theory. The most frequently addressed implementation concepts were Acceptability, Feasibility, and Effectiveness, while Cost, Cost-Effectiveness, and Maintenance were rarely reported. Solutions to common barriers included the importance of good stakeholder relationships and engagement, a manualised intervention flexible enough to adapt to the context, and ensuring facilitators were well-trained, confident, and enthusiastic.
尽管有确凿证据表明针对老年人的认知干预可改善认知、情绪和日常功能，但在临床或社区实践中实施的此类干预却很少。本范围综述旨在了解所使用的实施框架和方法及其对老年人认知干预实施成功的贡献。我们遵循系统评价和元分析扩展的首选报告项目（PRISMA-ScR），并搜索了CINAHL、EMBASE、MEDLINE和PSYCINFO数据库，使用了与认知干预、实施和老年人相关的术语。这产生了5002项研究，经过迭代过程后纳入了其中29项。大多数研究报告了针对痴呆症患者的认知刺激实施情况。只有四项研究使用了正式的实施框架，三项使用了RE-AIM，一项使用了基于复杂性理论的过程评估。最常涉及的实施概念是可接受性、可行性和有效性，而成本、成本效益和维持情况很少被报告。常见障碍的解决方案包括良好的利益相关者关系和参与的重要性、足够灵活以适应环境的手册化干预，以及确保促进者训练有素、自信且热情。
