针对社区轻度认知障碍(MCI)患者的个性化计算机认知训练(iCCT):随机对照试验(MCI-CCT 研究)6 个月干预期的认知结果。

IF 7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Elmar Graessel, Michael Jank, Petra Scheerbaum, Julia-Sophia Scheuermann, Anna Pendergrass
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引用次数: 0

摘要

背景:计算机化认知训练(CCT)可以提高轻度认知障碍(MCI)患者的认知能力,尤其是当CCT包含学习系统时,这种学习系统是一种机器学习(ML),它可以自动选择与患者最高表现相对应的练习难度,从而实现个性化训练:方法:我们为积极对照组(CG)开发了一种带 ML 的个性化 CCT(iCCT)和一种基本 CCT(bCCT)。该研究旨在确定,在为期 6 个月的时间内,干预组(IG)的 iCCT 与对照组的 bCCT 相比,是否能显著提高 MCI 患者(60 岁以上)的整体认知功能。这项双盲随机对照研究完全通过虚拟方式进行。89 名参与者都是居住在德国的社区居民,经心理测量诊断患有 MCI。iCCT 可刺激各种认知功能,尤其是工作记忆、视觉结构推理和决策。bCCT 包含的任务较少且简单。两种 CCT 均在家中使用。在基线和 6 个月后,我们使用蒙特利尔认知评估(MoCA)对认知功能进行了评估。主要分析采用了混合模型方差分析:结果:两种 CCT 均显著提高了平均整体认知能力。在CG中,MoCA得分的估计边际平均值从22.3(SE = 0.25)分到23.2(SE = 0.41)分,平均增加了0.9分(95% CI [0.2,1.7])(P = 0.018);在IG中,MoCA得分从21.9(SE = 0.26)分到24.1(SE = 0.42)分,平均增加了2.2分(95% CI [1.4,2.9])(P 2 = 0.057)。参与者平均每周使用三次 CCT,每次平均持续时间为 34.9 分钟。与 bCCT 相比,iCCT 被认为更具吸引力和刺激性:通过每周三次、每次 30 分钟的多任务 CCT,居家 MCI 患者可在 6 个月内显著提高认知能力。使用多任务CCT能明显提高认知能力训练的效果,并提高使用者的满意度:试验注册:ISRCTN14437015;注册日期:2020 年 2 月 27 日。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Individualised computerised cognitive training (iCCT) for community-dwelling people with mild cognitive impairment (MCI): results on cognition in the 6-month intervention period of a randomised controlled trial (MCI-CCT study).

Background: Computerised cognitive training (CCT) can improve the cognitive abilities of people with mild cognitive impairment (MCI), especially when the CCT contains a learning system, which is a type of machine learning (ML) that automatically selects exercises at a difficulty that corresponds to the person's peak performance and thus enables individualised training.

Methods: We developed one individualised CCT (iCCT) with ML and one basic CCT (bCCT) for an active control group (CG). The study aimed to determine whether iCCT in the intervention group (IG) resulted in significantly greater enhancements in overall cognitive functioning for individuals with MCI (age 60+) compared with bCCT in the CG across a 6-month period. This double-blind randomised controlled study was conducted entirely virtually. The 89 participants were community-dwelling people with a psychometric diagnosis of MCI living in Germany. The iCCT stimulates various cognitive functions, especially working memory, visuo-constructional reasoning, and decision-making. The bCCT includes fewer and simpler tasks. Both CCTs were used at home. At baseline and after 6 months, we assessed cognitive functioning with the Montreal Cognitive Assessment (MoCA). A mixed-model ANCOVA was conducted as the main analysis.

Results: Both CCTs led to significant increases in average global cognition. The estimated marginal means of the MoCA score increased significantly in the CG by an average of 0.9 points (95% CI [0.2, 1.7]) from 22.3 (SE = 0.25) to 23.2 (SE = 0.41) points (p = 0.018); in the IG, the MoCA score increased by an average of 2.2 points (95% CI [1.4, 2.9]) from 21.9 (SE = 0.26) to 24.1 (SE = 0.42) points (p < 0.001). In a confound-adjusted multiple regression model, the interaction between time and group was statistically significant (F = 4.92; p = 0.029). The effect size was small to medium (partial η2 = 0.057). On average, the participants used the CCTs three times per week with an average duration of 34.9 min per application. The iCCT was evaluated as more attractive and more stimulating than the bCCT.

Conclusions: By using a multi-tasking CCT three times a week for 30 min, people with MCI living at home can significantly improve their cognitive abilities within 6 months. The use of ML significantly increases the effectiveness of cognitive training and improves user satisfaction.

Trial registration: ISRCTN14437015; registered February 27, 2020.

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来源期刊
BMC Medicine
BMC Medicine 医学-医学:内科
CiteScore
13.10
自引率
1.10%
发文量
435
审稿时长
4-8 weeks
期刊介绍: BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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