Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature
Computerized and Virtual Reality Cognitive Training for Individuals at High Risk of Cognitive Decline: Systematic Review of the Literature
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DOI：
10.1016/j.jagp.2014.04.009
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发表时间：
2015-04-01
影响因子：
7.2
通讯作者：
Solowij, Nadia
中科院分区：
文献类型：
--
作者：
Coyle, Hannah;Traynor, Victoria;Solowij, Nadia
本研究的目的是评估认知训练的效果，特别是计算机化认知训练（CCT）和虚拟现实认知训练（VRCT），这些项目适用于患有轻度认知障碍（MCI）或痴呆症的个体，因此具有认知能力下降的高风险。在检索了一系列学术数据库（CINHAL、PSYCinfo和Web of Science）后，评估的研究（N = 16）被分类为CCT （N = 10）、VRCT （N = 3）和多模态干预（N = 3）。计算了效应量，但由于采用的研究设计和结果测量方法存在很大的可变性，因此无法进行荟萃分析。注意力、执行功能和记忆（视觉和语言）的认知领域表现出最一致的改善。对心理结果的积极影响（N = 6）是抑郁症状（N = 3）和焦虑（N = 2）的显著减轻，以及记忆策略使用感知的改善（N = 1）。日常生活活动评估显示无显著改善（N = 8）。随访研究（N = 5）显示认知和心理结局的长期改善（N = 3），与对照组的认知功能下降相比，干预组表现出认知功能的平台效应（N = 2）。CCT和VRCT在长期改善认知能力方面对认知能力下降高危人群有中等效果。总干预时间不影响疗效。未来的研究需要通过纳入更大的样本、纵向设计和更大范围的结果测量（包括功能和生活质量测量）来改进研究设计，以评估认知训练对认知能力下降高风险个体的更广泛影响。
The aim of this study was to assess the efficacy of cognitive training, specifically computerized cognitive training (CCT) and virtual reality cognitive training (VRCT), programs for individuals living with mild cognitive impairment (MCI) or dementia and therefore at high risk of cognitive decline. After searching a range of academic databases (CINHAL, PSYCinfo, and Web of Science), the studies evaluated (N = 16) were categorized as CCT (N = 10), VRCT (N = 3), and multimodal interventions (N = 3). Effect sizes were calculated, but a meta-analysis was not possible because of the large variability of study design and outcome measures adopted. The cognitive domains of attention, executive function, and memory (visual and verbal) showed the most consistent improvements. The positive effects on psychological outcomes (N = 6) were significant reductions on depressive symptoms (N = 3) and anxiety (N = 2) and improved perceived use of memory strategy (N = 1). Assessments of activities of daily living demonstrated no significant improvements (N = 8). Follow-up studies (N = 5) demonstrated long-term improvements in cognitive and psychological outcomes (N = 3), and the intervention groups showed a plateau effect of cognitive functioning compared with the cognitive decline experienced by control groups (N = 2). CCT and VRCT were moderately effective in long-term improvement of cognition for those at high risk of cognitive decline. Total intervention time did not mediate efficacy. Future research needs to improve study design by including larger samples, longitudinal designs, and a greater range of outcome measures, including functional and quality of life measures, to assess the wider effect of cognitive training on individuals at high risk of cognitive decline.