Computerized Cognitive Training in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis
Computerized Cognitive Training in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis
复制标题
针对轻度认知障碍或痴呆老年人的计算机化认知训练：一项系统综述和荟萃分析
DOI：
10.1176/appi.ajp.2016.16030360
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发表时间：
2017-04-01
影响因子：
17.7
通讯作者：
Lampit, Amit
中科院分区：
文献类型：
--
作者：
Hill, Nicole T. M.;Mowszowski, Loren;Lampit, Amit
目的：先前的荟萃分析表明，计算机认知训练（CCT）是一种安全有效的老年人认知干预措施。然而，疗效因人群和认知领域而异，对CCT在轻度认知障碍或痴呆患者中的疗效知之甚少。方法：作者检索了Medline、Embase、PsychINFO、CINAHL和CENTRAL，截至2016年7月1日，对CCT在老年轻度认知障碍或痴呆患者中的随机对照试验进行了检索。结果：在17项试验中，轻度认知功能障碍对认知的总体影响为中度（Hedges' g =0.35，95%CI =0.20-0.51），轻度认知功能障碍对认知的总体影响为中度（Hedges' g=0.35，95%CI = 0.51）。没有证据表明活性和被动对照试验之间存在出版偏倚或差异。对整体认知、注意力、工作记忆、学习和记忆（非语言记忆除外）以及心理社会功能（包括抑郁症状）有小至中度影响。在痴呆症，统计学上显着的影响被发现对整体认知（k=11，g=0.26，95%CI =0.01-0.52）和视觉空间技能，但这些都是由三个试验的虚拟现实或任天堂WII.Conclusions：CCT是有效的全球认知，选择认知领域，和社会心理功能在轻度认知障碍的人。因此，这种干预措施需要进行更长期和更大规模的试验，以检查对痴呆症转化的影响。相反，对痴呆症患者有效的证据很弱，并且仅限于沉浸式技术的试验。
Objective: Previous meta-analyses indicate that computerized cognitive training (CCT) is a safe and efficacious intervention for cognition in older adults. However, efficacy varies across populations and cognitive domains, and little is known about the efficacy of CCT in people with mild cognitive impairment or dementia.Method: The authors searched Medline, Embase, PsychINFO, CINAHL, and CENTRAL through July 1, 2016, for randomized controlled trials of CCT in older adults with mild cognitive impairment or dementia. Overall cognition, individual cognitive domains, psychosocial function, and activities of daily living were pooled separately for mild cognitive impairment and dementia trials.Results: The overall effect on cognition in mild cognitive impairment across 17 trials was moderate (Hedges' g=0.35, 95% CI=0.20-0.51). There was no evidence of publication bias or difference between active-and passive-controlled trials. Small to moderate effects were found for global cognition, attention, working memory, learning, and memory, with the exception of nonverbal memory, and for psychosocial functioning, including depressive symptoms. In dementia, statistically significant effects were found on overall cognition (k=11, g=0.26, 95% CI=0.01-0.52) and visuospatial skills, but these were driven by three trials of virtual reality or Nintendo Wii.Conclusions: CCT is efficacious on global cognition, select cognitive domains, and psychosocial functioning in people with mild cognitive impairment. This intervention therefore warrants longer-term and larger-scale trials to examine effects on conversion to dementia. Conversely, evidence for efficacy in people with dementia is weak and limited to trials of immersive technologies.