自适应认知训练对轻度阿尔茨海默病患者的干预作用

Intervention effect of adaptive cognitive training in patients with mild Alzheimer's disease

目的:探讨自适应认知训练对轻度阿尔茨海默病(AD)患者的干预效果。方法:将60例轻度AD患者随机分为两组;对照组(30例)不采用任何相关干预措施;干预组(30例)采用中文版自适应认知控制(ACE)软件,以iPAD为训练媒介,进行为期12周的侧抑制、方框测验、点击描线、持续注意、心理旋转及空间线索6项训练。干预前后采用蒙特利尔认知评估量表(MoCA)、认知评估量表5项(ACE-5)评估两组认知功能,采用患者健康问卷-9项(PHQ-9)、广泛性焦虑量表-7项(GAD-7)评估干预前后患者情绪变化。结果:MoCA:各组干预前后自身对照及两组间评分比较差异无统计学意义。ACE-5:干预组基础反应时间、字色干扰、任务转换平均反应时间明显少于干预前,空间记忆广度正确应答明显多于干预前(P<0.05或P<0.01);辨识力评分与干预前比较差异无统计学意义。对照组基础反应时间、字色干扰、空间记忆广度评分较基线明显下降(P均<0.05),任务转换、辨识力评分较基线差异无统计学意义。干预后干预组ACE-5中各项分测验成绩明显优于对照组(P均<0.01)。结论:12周自适应认知训练对轻度AD患者部分认知控制损害有一定改善作用。

Objective:To investigate the intervention effect of adaptive cognitive training on patients with mild Alzheimer's disease(AD).Method:60 patients with mild AD were randomly divided into two groups.The control group(30 cases)did not receive any relevant intervention while the intervention group(30 cases)received 12 weeks of cognitive training using Chinese version of adaptive cognitive evaluation(ACE)application,which ran on the iPad including 6 sub-tests:flanker,boxed,tap&trace(TNT),sustained attention(SAAT),mental rotation and spatial cueing.Montreal cognitive assessment(MoCA)and adaptive cognitive evaluation-5(ACE-5)were used to evaluate the cognitive function.Patient health questionnaire-9 items(PHQ-9)and generalized anxiety scale-7 items(GAD-7)were used to evaluate emotional state.Results:MoCA:There were no significant differences in scores within or between two groups after intervention.ACE-5:Average response time of the intervention group in Basic Response Time(BRT),Stroop,Task Switch sub-tests were less than those before intervention,correct response in Spatial Span was higher after intervention(P<0.05 or P<0.01).There were no significant differences from the baseline in discrimination scores after intervention in intervention group.Average response time of BRT,Stroop and spatial span scores of the control group were significantly lower than base line(all P<0.05).There were no significant differences from the baseline in discrimination and task switch scores in the control group.The score of ACE-5 sub-tests in the intervention group were higher than those in the control group after intervention(all P<0.01).Conclusion:Twelve weeks of adaptive cognitive training can improve some domains of cognitive control impairment in patients with mild AD.