Home-based cognitive remediation and transcranial direct current stimulation to enhance cognition in older adults with major depressive disorder or mild cognitive impairment: An open label study.

IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY
François Genadry, Priyanka Kalyani, Bishoy M Elgallab, Heather Brooks, Daniel M Blumberger, Sanjeev Kumar, Benoit H Mulsant, Christopher R Bowie, Tarek K Rajji
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引用次数: 0

Abstract

Objectives: Interventions to prevent dementia among older adults with high-risk conditions such as Mild Cognitive Impairment (MCI) or Major Depressive Disorder (MDD) are highly needed. This study assessed the feasibility, adherence, safety, and clinical effects of home-based Cognitive Remediation (CR) with transcranial Direct Current Stimulation (tDCS) delivered by study partners in these populations.

Design: Open-label study.

Participants: Patients with a diagnosis of MCI, MDD in remission (rMDD), or both, were enrolled as a couple with their study partners.

Intervention: Home-based CR+tDCS, five days/week for eight weeks and then CR online with one week of CR+tDCS boosters every six months for up to two years.

Methods: Nineteen couples were enrolled. Cognitive testing was administered at baseline, after the 8-week phase, and then yearly from baseline for up to two years. Measures of feasibility, adherence and safety and clinical and cognitive outcomes were collected.

Results: Study partners experienced increased perceived competence in delivering the intervention [F (1, 164) = 18.87, p < 0.001]. Eighty percent of the 8-week sessions were completed by 84 % of the patients; 56 % of the patients completed the 2-year intervention. Improvement in global cognition was observed in patients [F (3, 15.1) = 4.04, p = 0.027], and in quality of life in study partners [F (3, 30.6) = 6.18, p = 0.002].

Conclusions: This study demonstrates that home-based CR+tDCS is feasible and safe in patients with MCI or rMDD, and could improve cognition in patients and quality of life in study partners. Randomized controlled trials are needed to confirm these findings.

基于家庭的认知修复和经颅直流电刺激增强老年人重度抑郁症或轻度认知障碍的认知:一项开放标签研究
目的:预防老年痴呆的干预措施,如轻度认知障碍(MCI)或重度抑郁障碍(MDD)的高风险条件是非常必要的。本研究评估了研究伙伴在这些人群中使用经颅直流电刺激(tDCS)进行家庭认知修复(CR)的可行性、依从性、安全性和临床效果。设计:开放标签研究。参与者:诊断为轻度认知障碍(MCI)、重度抑郁症缓解期(rMDD)或两者兼而有之的患者,与他们的研究伙伴作为夫妇入组。干预:以家庭为基础的CR+tDCS,每周5天,持续8周,然后每6个月在线CR+ 1周的CR+tDCS增强剂,持续两年。方法:纳入19对夫妇。认知测试在8周后的基线进行,然后从基线开始每年进行一次,持续两年。收集可行性、依从性和安全性以及临床和认知结果的措施。结果:研究伙伴在实施干预时感知能力有所提高[F (1,164) = 18.87, p]结论:本研究表明,基于家庭的CR+tDCS对MCI或rMDD患者是可行和安全的,可以改善患者的认知和研究伙伴的生活质量。需要随机对照试验来证实这些发现。
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来源期刊
International psychogeriatrics
International psychogeriatrics 医学-精神病学
CiteScore
9.10
自引率
8.60%
发文量
217
审稿时长
3-6 weeks
期刊介绍: A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
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