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数字技术干预对老年人认知功能的有效性:随机对照试验的系统评价和荟萃分析

The effectiveness of digital technology interventions for cognitive function in older adults: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Chen Chen, Huang Ning, Hu Ban, Zhang Mingyu, Yuan Junliang, Guo Jing

机构信息

Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, P.R. China.

Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, P.R. China.

出版信息

Geroscience. 2025 Feb;47(1):653-683. doi: 10.1007/s11357-024-01446-z. Epub 2024 Dec 17.

Abstract

Digital technology interventions (DTIs) are seen as promising interventions to prevent or delay cognitive decline in older adults, yet evidence from reviews is not conclusive. The aim of this study is to explore the effectiveness of DTIs in improving older adults' cognitive function while taking study design and intervention characteristics as moderators. We searched the PubMed, Embase, CINAHL, PsycINFO, and Scopus databases up to May 26, 2023. Only randomized controlled trials examined the effects of DTIs on cognitive function were included in our study. Standardized mean difference (SMD) and 95% confidence interval for outcomes were applied in meta-analyses and subgroup analyses. A risk of bias assessment was also conducted. Overall, 23 eligible studies with a total sample size of 1454 participants were included. We found that DTIs significantly improved global cognitive function (SMD = 0.479), attention and processing speed (SMD = 0.488), executive function (SMD = 0.287), immediate recall (SMD = 0.266), and working memory (SMD = 0.307). Our subgroup analyses revealed that DTIs were more effective for cognitively impaired subjects, and DTIs with specific intervention characteristics, such as the inclusion of cognitive standard tasks, virtual reality-based interventions, specialized settings, professional guidance, low/medium-density training, > 24 sessions, and sessions lasting > 30 min, were more effective for different cognitive domains. This study supported the effectiveness of DTIs in improving cognitive function in older adults aged 60 years old and over, which may be influenced by study design and intervention characteristics. These findings have important implications for clinical dementia prevention and treatment strategies targeted at specific cognitive domains.

摘要

数字技术干预措施(DTIs)被视为预防或延缓老年人认知衰退的有前景的干预措施,但综述的证据并不确凿。本研究的目的是探讨DTIs在改善老年人认知功能方面的有效性,同时将研究设计和干预特征作为调节因素。我们检索了截至2023年5月26日的PubMed、Embase、CINAHL、PsycINFO和Scopus数据库。我们的研究仅纳入了检验DTIs对认知功能影响的随机对照试验。荟萃分析和亚组分析采用了标准化均数差(SMD)和结局的95%置信区间。还进行了偏倚风险评估。总体而言,纳入了23项符合条件的研究,总样本量为1454名参与者。我们发现DTIs显著改善了整体认知功能(SMD = 0.479)、注意力和处理速度(SMD = 0.488)、执行功能(SMD = 0.287)、即时回忆(SMD = 0.266)和工作记忆(SMD = 0.307)。我们的亚组分析显示,DTIs对认知受损受试者更有效,具有特定干预特征的DTIs,如纳入认知标准任务、基于虚拟现实的干预、专门设置、专业指导、低/中密度训练、超过24次训练以及每次训练持续超过30分钟,对不同认知领域更有效。本研究支持DTIs在改善60岁及以上老年人认知功能方面的有效性,这可能受研究设计和干预特征的影响。这些发现对针对特定认知领域的临床痴呆预防和治疗策略具有重要意义。

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