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Mindfulness-Based Training Does Not Improve Neuropsychological Outcomes in Mild Cognitive Impairment More Than Spontaneous Reversion Rates: A Randomized Controlled Trial
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-09-15 , DOI: 10.3233/jad-215035 Kinjal Doshi 1 , Stacey L Henderson 1 , Qianqian Fan 2 , Kian F Wong 3 , Julian Lim 3, 4
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-09-15 , DOI: 10.3233/jad-215035 Kinjal Doshi 1 , Stacey L Henderson 1 , Qianqian Fan 2 , Kian F Wong 3 , Julian Lim 3, 4
Affiliation
Background:Current pharmacological and behavioral treatment options for mild cognitive impairment (MCI) are limited, motivating a search for alternative therapies that might slow the progression of cognitive decline. Objective:We investigated the effectiveness of a cognition-focused mindfulness-based intervention. Methods:An open-label, three arm randomized controlled trial was conducted at a public tertiary medical center. Older persons (ages 45–75; N = 76) diagnosed with MCI were recruited and randomized into either Mindfulness-based training (MBT), cognitive rehabilitation therapy (CRT), or treatment as usual (TAU). Participants in the intervention arms received 8 weekly 2-h sessions delivered in a group setting and engaged in home practice. Primary outcomes measures included changes in index scores for attention, immediate memory, and delayed memory as measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Depression was a secondary outcome. Results:Using intent-to-treat analysis, we found that participants receiving MBT showed significant improvements in global cognition (d = 0.26; [95%CI 0.03–0.56]) and delayed memory (d = 0.36; [95%CI 0.17–0.57]), with significantly greater improvements in delayed memory than CRT (ηp2 = 0.10). However, there was no benefit of MBT over TAU. No change in depression was observed in the MBT group. Reductions in depression were associated with improvements in cognitive functioning in the MBT group only. Conclusion:Our results suggest that a cognition-focused MBT did not improve cognitive functioning in MCI patients substantially more than spontaneous reversion rates, possibly as mood symptoms were not significantly alleviated in this group.
中文翻译:
以正念为基础的训练对轻度认知障碍的神经心理结果的改善作用大于自发回复率:一项随机对照试验
背景:目前针对轻度认知障碍 (MCI) 的药理学和行为治疗选择有限,促使人们寻找可能减缓认知能力下降进程的替代疗法。目的:我们调查了以认知为中心的正念干预的有效性。方法:在公立三级医疗中心进行了一项开放标签、三臂随机对照试验。招募被诊断患有 MCI 的老年人(45-75 岁;N = 76)并随机接受基于正念的训练 (MBT)、认知康复治疗 (CRT) 或常规治疗 (TAU)。干预组的参与者每周接受 8 次 2 小时的小组训练并参与家庭练习。主要结果测量包括注意力、即时记忆、和延迟记忆,使用神经心理状态评估的可重复电池 (RBANS) 测量。抑郁是次要结果。结果:使用意向治疗分析,我们发现接受 MBT 的参与者在整体认知(d = 0.26;[95%CI 0.03–0.56])和延迟记忆(d = 0.36;[95%CI 0.17– 0.57]),延迟记忆的改善明显大于 CRT(ηp2 = 0.10)。然而,与 TAU 相比,MBT 没有任何优势。在 MBT 组中没有观察到抑郁症的变化。抑郁症的减少仅与 MBT 组的认知功能改善有关。结论:我们的结果表明,与自发逆转率相比,以认知为重点的 MBT 并没有显着改善 MCI 患者的认知功能,
更新日期:2021-09-17
中文翻译:
以正念为基础的训练对轻度认知障碍的神经心理结果的改善作用大于自发回复率:一项随机对照试验
背景:目前针对轻度认知障碍 (MCI) 的药理学和行为治疗选择有限,促使人们寻找可能减缓认知能力下降进程的替代疗法。目的:我们调查了以认知为中心的正念干预的有效性。方法:在公立三级医疗中心进行了一项开放标签、三臂随机对照试验。招募被诊断患有 MCI 的老年人(45-75 岁;N = 76)并随机接受基于正念的训练 (MBT)、认知康复治疗 (CRT) 或常规治疗 (TAU)。干预组的参与者每周接受 8 次 2 小时的小组训练并参与家庭练习。主要结果测量包括注意力、即时记忆、和延迟记忆,使用神经心理状态评估的可重复电池 (RBANS) 测量。抑郁是次要结果。结果:使用意向治疗分析,我们发现接受 MBT 的参与者在整体认知(d = 0.26;[95%CI 0.03–0.56])和延迟记忆(d = 0.36;[95%CI 0.17– 0.57]),延迟记忆的改善明显大于 CRT(ηp2 = 0.10)。然而,与 TAU 相比,MBT 没有任何优势。在 MBT 组中没有观察到抑郁症的变化。抑郁症的减少仅与 MBT 组的认知功能改善有关。结论:我们的结果表明,与自发逆转率相比,以认知为重点的 MBT 并没有显着改善 MCI 患者的认知功能,