评估基于正念的认知融合训练项目对轻度认知障碍老年人健康结果的可靠和临床显著变化:一项随机对照试验

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Yinxia Ren, Bei Wu, Chenxi Ge, Lulu Shi, Chen Zhang, Mengna Zhu, Dan Zhao, Lina Wang
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引用次数: 0

摘要

背景:认识到可感知的压力是一个可改变的风险因素,正念为基础的项目显示出减轻轻度认知障碍(MCI)老年人压力的希望。目的:评估基于正念的情境认知融合训练(M-bCCDT)计划对感知压力和其他健康结果的疗效,并在个体水平上检查这些改善在老年MCI患者中的可靠性和临床意义。设计:两组、评估者盲法随机对照试验。环境和参与者:102名社区居住的轻度认知障碍老年人。方法:参与者被随机分配到M-bCCDT项目(每周60分钟,持续8周,随后是12周的无监督练习)或健康促进课程。在基线(T0)、8周(T1)和20周(T2)收集感知应激、记忆功能、整体认知功能、精神运动速度和正念意识的测量结果。在组水平(Generalized estimation Equation, GEE)和个体水平(Reliable and clinical Significant Changes, RCSC)评估干预效果。结果:经GEE分析,M-bCCDT方案与等候名单对照组相比,在感知应激方面表现出显著的交互效应(βT1 = -3.686, 95% CI [-5.397, -1.976];βt2 = -7.608, 95% ci[-9.387, -5.829])。此外,该程序在记忆功能,精神运动速度和正念意识方面也显示出显着的疗效。RCSC显示,干预组有30名(59%)参与者在8周时感知压力有统计学显著改善,其中7名(14%)有临床显著改善。在20周时,这一数字增加到38例(75%),其中20例(39%)具有临床意义。随着时间的推移,次要结果也显示出统计学和临床意义上的显著改善,但在个体水平上,整体认知功能没有改善。结论:M-bCCDT计划对老年MCI患者的感知压力和正念意识有积极影响,促进了记忆和精神运动速度的改善,这些益处持续了20周。它为社区卫生保健提供者提供了MCI压力管理的系统方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating reliable and clinically significant changes in health outcomes of a mindfulness-based cognitive defusion training program among older adults with mild cognitive impairment: a randomized controlled trial.

Background: Recognizing perceived stress as a modifiable risk factor, mindfulness-based programs show promise for stress mitigation in older adults with mild cognitive impairment (MCI).

Objective: To assess the efficacy of a mindfulness-based contextual cognitive defusion training (M-bCCDT) program on perceived stress and other health outcomes, and to examine the reliable and clinically significance of these improvements at individual-level among older adults with MCI.

Design: A two-arm, assessor-blinded randomized controlled trial.

Settings and participants: 102 community-dwelling older adults with MCI.

Methods: Participants were randomly allocated to either a M-bCCDT program (weekly 60-minute sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or health promotion classes. Measures of perceived stress, memory function, global cognitive function, psychomotor speed and mindfulness awareness were collected at baseline (T0), 8-week (T1) and 20-week (T2). Intervention effects were assessed at a group level (Generalized Estimating Equation, GEE) and individual level (Reliable and Clinically Significant Changes, RCSC).

Results: The M-bCCDT program demonstrated significant interaction effects in perceived stress compared to the wait-list control group by GEE analysis (βT1 = -3.686, 95% CI [-5.397, -1.976]; βT2 = -7.608, 95% CI [-9.387, -5.829]). Furthermore, this program also showed significant efficacy in memory function, psychomotor speed and mindfulness awareness. RCSC indicated that 30 participants (59%) in the intervention group showed statistically significant improvement in perceived stress at 8-week, with 7 (14%) clinically significant. This increased to 38 (75%) with 20 (39%) clinically significant at 20-week. Secondary outcomes also showed statistically and clinically significant improvements over time, but no improvement in global cognitive function at the individual level.

Conclusions: The M-bCCDT program positively impacted perceived stress and mindfulness awareness in older adults with MCI, facilitating the improvements in memory and psychomotor speed, with these benefits sustained for 20 weeks. It offers a systematic approach for community healthcare providers in MCI stress management.

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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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