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Cognition-oriented treatments for older adults: A systematic review of the influence of depression and self-efficacy individual differences factors
Neuropsychological Rehabilitation ( IF 2.7 ) Pub Date : 2021-01-28 , DOI: 10.1080/09602011.2020.1869567
Shannon L Webb 1 , Damian P Birney 1 , Vanessa Loh 1 , Sarah Walker 1 , Amit Lampit 2 , Alex Bahar-Fuchs 2
Affiliation  

ABSTRACT

The increasing prevalence of cognitive decline, mild cognitive impairment (MCI), and dementia with the aging population has led to scrutiny of the efficacy of cognition-oriented treatments (COTs) aiming to maintain functioning, and delay or prevent further cognitive decline. However, little is known regarding the role of individual differences patient-variables (such as depression, self-efficacy, and motivation) in moderating the efficacy of COTs. This systematic review aimed to identify and analyze COT trials which investigated the relationship between differences in these patient-variables and intervention outcomes for older adults across healthy, MCI, and dementia populations. Of the 4854 studies extracted from the systematic search, 14 were included for analysis. While results were mixed across interventions and populations, on balance, greater depression severity predicted poorer cognitive functioning, and improvement in depressive symptom severity may account for at least part of the cognitive benefits seen at post-intervention. These findings were strongest for studies of MCI populations, with there being limited evidence of a relationship for healthy older adults or those with dementia. Overall, this review demonstrates the need for further investigation into the role of individual differences and clinical variables – particularly depression symptom severity – in attenuating COT outcomes through larger sample, high-quality randomized controlled trials.



中文翻译:

老年人认知导向治疗:抑郁和自我效能个体差异因素影响的系统评价

摘要

随着人口老龄化,认知能力下降、轻度认知障碍 (MCI) 和痴呆症的患病率越来越高,导致人们对旨在维持功能、延缓或预防进一步认知能力下降的认知导向治疗 (COT) 的功效进行审查。然而,关于个体差异患者变量(如抑郁、自我效能和动机)在调节 COT 疗效中的作用知之甚少。该系统评价旨在确定和分析 COT 试验,这些试验调查了这些患者变量的差异与健康、MCI 和痴呆人群中老年人的干预结果之间的关系。从系统检索中提取的 4854 项研究中,有 14 项被纳入分析。虽然干预措施和人群的结果参差不齐,但总的来说,抑郁症严重程度越高,认知功能越差,抑郁症状严重程度的改善可能至少是干预后认知益处的一部分。这些发现对于 MCI 人群的研究最为有力,只有有限的证据表明健康老年人或痴呆症患者之间存在关系。总体而言,本综述表明有必要通过更大样本的高质量随机对照试验进一步研究个体差异和临床变量(尤其是抑郁症状严重程度)在减弱 COT 结局方面的作用。这些发现对于 MCI 人群的研究最为有力,只有有限的证据表明健康老年人或痴呆症患者之间存在关系。总体而言,本综述表明有必要通过更大样本的高质量随机对照试验进一步研究个体差异和临床变量(尤其是抑郁症状严重程度)在减弱 COT 结局方面的作用。这些发现对于 MCI 人群的研究最为有力,只有有限的证据表明健康老年人或痴呆症患者之间存在关系。总体而言,本综述表明有必要通过更大样本的高质量随机对照试验进一步研究个体差异和临床变量(尤其是抑郁症状严重程度)在减弱 COT 结局方面的作用。

更新日期:2021-01-28
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