A Randomised Clinical Trial of Cognitive Activity for Older Adults with Mild Cognitive Impairment

澳大利亚的人口正在迅速老龄化，与年龄有关的疾病的频率也在迅速上升。痴呆症是老年人最常见的精神健康障碍之一，也是澳大利亚因残疾而损失多年生命的主要原因之一。老年轻度认知障碍（MCI）被认为是潜在预测未来认知能力下降的重要临床状态。越来越多的证据表明，针对潜在的可改变的危险因素可以延迟痴呆症的发病。在老年人中，经常参加精神刺激的休闲活动与更强的认知（如记忆能力）表现和降低痴呆风险有关。此外，认知和功能衰退的速度可能受到认知干预策略的影响，尽管很少有随机对照研究对诊断为轻度认知障碍的个体进行了这些研究。本研究的主要焦点是确定一个结构化的认知活动计划（CA）是否可以延缓老年MCI患者认知能力下降的进展。160名老年人将被随机（像抛硬币一样随机）分为两组，一组是为期10周的CA干预，重点是认知训练和康复技术，另一组是为期10周的对照教育干预，提供有关老龄化和退休的信息。在随访期间监测患者的认知能力、生活质量和功能水平。提出的研究将提高对可能的认知改变因素的理解，并强调在老年人群中进行干预的潜力。获得的结果将对有关卫生保健资源的政策建议产生影响，并促进改变MCI患者的方法和管理。

Australia’s population is ageing rapidly and so is the frequency of age-related disorders. Dementia is one of the most frequent mental health disorders of older people and one of the leading causes of years of life lost due to disability in Australia. Mild Cognitive Impairment (MCI) in old age is considered an important clinical state potentially predictive of future cognitive decline. There is increasing evidence that the onset of dementia can be delayed with targeting potentially modifiable risk factors. In older adults, frequent participation in mentally stimulating leisure activities has been associated with stronger cognitive (abilities such as memory) performances and reduced risk of dementia. Further, the rate of cognitive and functional decline can be influenced by cognitive intervention strategies, though few randomised control studies have explored these findings with individuals who have a diagnosis of MCI. The primary focus of this research is to determine whether a structured program of cognitive activity (CA) can delay progression of cognitive decline amongst older adults with MCI. 160 older adults will be randomised (by chance, like the flip of a coin) to either a 10 week CA intervention with a focus on cognitive training and rehabilitation techniques or a 10 week control educational intervention providing information on aging and retirement. Their cognitive performance, quality of life and functional level will be monitored during follow-up. The proposed study will improve the understanding of possible modifying factors of cognition and highlight the potential of intervention in an older age population. The obtained results will have implications for policy recommendations regarding health care resources and facilitate changes in the approach and management of individuals with MCI.