Is Cognitive Training an Effective Treatment for Preclinical and Early Alzheimer's Disease?
Is Cognitive Training an Effective Treatment for Preclinical and Early Alzheimer's Disease?
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DOI：
10.3233/jad-141302
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发表时间：
2014-01-01
影响因子：
4
通讯作者：
Sachdev, Perminder
中科院分区：
文献类型：
--
作者：
Gates, Nicola J.;Sachdev, Perminder
早期干预对预防或延缓阿尔茨海默病(AD)的痴呆有很大的兴趣。到目前为止，这方面的药物试验结果令人失望，非药物干预措施正受到越来越多的关注。一种这样的干预是复杂的认知活动。来自流行病学研究的证据表明，参与刺激精神活动与降低痴呆症风险有关。对健康成年人和有认知障碍的人引入新颖和复杂的认知干预可能是一种有效的治疗选择，可以改善认知，降低痴呆症的发病率，并减缓衰退的速度。本综述考察了恢复性认知训练(CT)的证据，并解决了一些与认知益处及其转移和持久性有关的临床相关问题。尽管随机对照试验的数量有限，但初步证据表明，CT可能会提供直接和长期的认知益处，这适用于非训练领域和非认知功能，其中有监督的小组多领域训练提供了最大的好处。讨论了可能的神经再生机制，并为进一步的研究和临床应用提供了建议。
There is much interest in early intervention for the prevention or postponement of dementia in Alzheimer's disease (AD). The results of drug trials in this regard have thus far been disappointing, and non-pharmacological interventions are receiving increased attention. One such intervention is complex cognitive activity. Evidence from epidemiological studies suggests that participation in stimulating mental activities is associated with lowered dementia risk. The introduction of novel and complex cognitive interventions to healthy adults and those with cognitive impairment may represent an efficacious treatment option to improve cognition, lower dementia incidence, and slow rate of decline. This review examines the evidence for restorative cognitive training (CT) and addresses a number of clinically relevant issues regarding cognitive benefit and its transfer and persistence. Although the number of randomized controlled trials is limited, preliminary evidence suggests that CT may provide immediate and longer term cognitive benefits which generalize to non-trained domains and non-cognitive functions, with supervised small group multi-domain training providing greatest benefits. Possible neuroplastic mechanisms are discussed, and recommendations for further research and clinical implementation provided.