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认知刺激对轻度认知障碍个体的有效性:一项系统评价和荟萃分析。

Effectiveness of cognitive stimulation for individuals with mild cognitive impairment: a systematic review and meta-analysis.

作者信息

Chen Lu Hua, Lee Oi Ling, Lee Yan Wing, Ng Shu Ting, Ngai Sum Yi Eugenia, Pau Yat Hei Zita, Ma Tongyu, Yuen Hon-Lam Joseph

机构信息

Deparment of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China

Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

BMJ Open. 2025 Jun 10;15(6):e090767. doi: 10.1136/bmjopen-2024-090767.

Abstract

OBJECTIVE

Cognitive stimulation (CS) is a non-pharmacological intervention aimed at enhancing cognitive function. However, the effectiveness of CS in individuals diagnosed with mild cognitive impairment (MCI) remains inconclusive. Therefore, this study aimed to assess the effectiveness of CS in improving cognitive function, psychological well-being, instrumental activities of daily living (IADL) and quality of life (QoL) in individuals with MCI, based on randomised controlled trials (RCTs).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Six English databases were systematically searched, including PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, American Psychological Association PsycInfo and Academic Search Premier.

ELIGIBILITY CRITERIA

RCTs about CS for individuals with MCI, published between January 2003 and December 2024.

DATA EXTRACTION AND SYNTHESIS

Data were extracted and assessed using the revised Cochrane risk of bias tool for randomised trials by independent researchers. The meta-analysis was conducted using the standardised mean difference (SMD) and 95% CIs of the included studies.

RESULTS

The meta-analysis included five eligible studies for the primary outcomes of cognitive function and three eligible studies for the secondary outcomes of psychological wellness. In the pooled samples, the CS intervention had a significant effect on cognitive function (SMD=0.63, 95% CI 0.25 to 1.01; p=0.001) and depression symptoms (SMD=-0.29, 95% CI -0.55 to -0.03; p=0.03) in individuals with MCI. However, no significant improvements in anxiety symptoms were identified after the CS intervention (SMD=-0.05; 95% CI -0.31 to 0.21; p=0.71).

CONCLUSION

The CS intervention can effectively improve cognitive function and alleviate depression symptoms. Although a meta-analysis was not conducted for IADL and QoL due to the limited number of included studies, positive trends in enhancing IADL performance and augmenting QoL were observed in individuals with MCI. However, due to the scarcity of relevant studies in this research field, more comprehensive RCTs are warranted to provide a better understanding of the potential benefits of CS and to guide its clinical application in the future.

PROSPERO REGISTRATION NUMBER

CRD42023494685.

摘要

目的

认知刺激(CS)是一种旨在增强认知功能的非药物干预措施。然而,CS对诊断为轻度认知障碍(MCI)的个体的有效性仍无定论。因此,本研究旨在基于随机对照试验(RCT)评估CS对改善MCI个体的认知功能、心理健康、日常生活工具性活动(IADL)和生活质量(QoL)的有效性。

设计

系统评价和荟萃分析。

数据来源

系统检索了六个英文数据库,包括PubMed、科学网、Embase、护理及相关健康文献累积索引、美国心理学会心理学文摘数据库和学术搜索高级版。

纳入标准

2003年1月至2024年12月期间发表的关于CS对MCI个体的RCT。

数据提取与合成

由独立研究人员使用修订后的Cochrane随机试验偏倚风险工具提取和评估数据。荟萃分析采用纳入研究的标准化均数差(SMD)和95%置信区间(CI)进行。

结果

荟萃分析纳入了五项关于认知功能主要结局的合格研究和三项关于心理健康次要结局的合格研究。在汇总样本中,CS干预对MCI个体的认知功能(SMD=0.63,95%CI 0.25至1.01;p=0.001)和抑郁症状(SMD=-0.29,95%CI -0.55至-0.03;p=0.03)有显著影响。然而,CS干预后未发现焦虑症状有显著改善(SMD=-0.05;95%CI -0.31至0.21;p=0.71)。

结论

CS干预可有效改善认知功能并减轻抑郁症状。尽管由于纳入研究数量有限未对IADL和QoL进行荟萃分析,但在MCI个体中观察到了IADL表现增强和QoL提高的积极趋势。然而,由于该研究领域相关研究较少,需要更全面的RCT来更好地了解CS的潜在益处并指导其未来的临床应用。

PROSPERO注册号:CRD42023494685。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3993/12161421/fdc328e8f175/bmjopen-15-6-g001.jpg

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