Computerized Cognitive Training for Older Adults at Higher Dementia Risk due to Diabetes: Findings From a Randomized Controlled Trial
Computerized Cognitive Training for Older Adults at Higher Dementia Risk due to Diabetes: Findings From a Randomized Controlled Trial
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DOI：
10.1093/gerona/glz073
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发表时间：
2020-04-01
影响因子：
5.1
通讯作者：
Beeri, Michel Schnaider
中科院分区：
文献类型：
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作者：
Bahar-Fuchs, Alex;Barendse, Marjolein E. A.;Beeri, Michel Schnaider
背景：评价适应性和个性化计算机化认知训练对老年糖尿病患者认知和疾病自我管理的影响。方法：单盲试验。84名居住在社区的老年糖尿病患者被随机分为定制和适应性计算机化认知训练组或通用、非定制或适应性计算机化认知训练组。两组都接受了8周的商用CogniFit程序培训，并接受了一系列行为改变技术的支持。每种情况下的参与者被进一步随机分配到整体或认知特异性自我效能干预组，或无自我效能组。干预后的主要结果是全局认知。次要结局包括糖尿病自我管理、元记忆、情绪和自我效能。评估分别在基线、培训后和6个月随访时进行。结果：在一般的计算机化认知训练条件下，依从性和保留性较低，但自我效能干预与依从性无关。在治疗后评估中，两种认知训练条件下的整体认知综合表现均有适度改善，在6个月的随访中观察到进一步的小幅改善。糖尿病自我管理的结果显示，在治疗后两种干预条件下，糖尿病自我评价护理有适度改善，并在6个月的随访中保持不变。结论：我们的研究结果表明，在以家庭为基础的多领域计算机化认知训练后，因糖尿病导致痴呆风险较高的老年人在认知和疾病自我管理方面都有改善。这些发现还表明，适应性困难和个人任务裁剪可能不是这些干预措施的关键组成部分。
Background: To evaluate the effects of adaptive and tailored computerized cognitive training on cognition and disease self-management in older adults with diabetes.Methods: This was a single-blind trial. Eighty-four community-dwelling older adults with diabetes were randomized into a tailored and adaptive computerized cognitive training or a generic, non-tailored or adaptive computerized cognitive training condition. Both groups trained for 8 weeks on the commercially available CogniFit program and were supported by a range of behavior change techniques. Participants in each condition were further randomized into a global or cognition-specific self-efficacy intervention, or to a no self-efficacy condition. The primary outcome was global cognition immediately following the intervention. Secondary outcomes included diabetes self-management, meta-memory, mood, and self-efficacy. Assessments were conducted at baseline, immediately after the training, and at a 6-month follow-up.Results: Adherence and retention were lower in the generic computerized cognitive training condition, but the self-efficacy intervention was not associated with adherence. Moderate improvements in performance on a global cognitive composite at the posttreatment assessments were observed in both cognitive training conditions, with further small improvement observed at the 6-month follow-up. Results for diabetes self-management showed a modest improvement on self-rated diabetes care for both intervention conditions following the treatment, which was maintained at the 6-month follow-up.Conclusions: Our findings suggest that older adults at higher dementia risk due to diabetes can show improvements in both cognition and disease self-management following home-based multidomain computerized cognitive training. These findings also suggest that adaptive difficulty and individual task tailoring may not be critical components of such interventions.