计算机化认知训练对认知功能障碍患者干预效果的系统评价再评价

Effectiveness of computerized cognitive training for patients with cognitive dysfunction: an overview of systematic reviews

目的对计算机化认知训练干预主观认知下降、轻度认知障碍及痴呆患者效果的系统评价进行再评价。方法检索PubMed、Embase、Web of Science、The Cochrane Library、CINAHL、中国生物医学文献数据库、中国知网、万方和维普数据库,由2名研究者独立进行文献筛选、资料提取和质量评价。结果共纳入14项Meta分析,结果显示计算机化认知训练可改善认知功能障碍患者的总体认知功能、记忆力和工作记忆,对日常生活活动能力和抑郁的干预效果有限,对焦虑、生活质量、神经精神症状和社会心理功能的影响尚不明确。结论计算机化认知训练可改善认知功能障碍患者的总体认知功能和部分认知域,但目前研究方法学质量、报告质量及证据质量欠佳,仍需更多设计严谨、过程规范的高质量研究为临床实践提供参考。

Objective To re-evaluate the systematic reviews on effectiveness of computerized cognitive training for patients with subjective cognitive decline,mild cognitive impairment or dementia.Methods We searched literature in PubMed,Embase,Web of Science,The Cochrane Library,CINAHL,CBM,CNKI,Wanfang and VIP Database.Two researchers screened the literature,extracted the data and evaluate the quality independently.Results Fourteen meta-analyses were included.Computerized cognitive training improved the overall cognitive function,memory and working memory of patients with cognitive dysfunction.But the effect on activities of daily living and depression was limited,and that on anxiety,quality of life,neuropsychiatric symptoms and psychosocial function was still unclear.Conclusion Computerized cognitive training can improve the overall cognitive function and some cognitive domains of patients with cognitive dysfunction.However,the methodological quality,reporting quality and evidence quality of the literature still need to be improved.More rigorously designed and standardized high-quality trials are still needed to provide reference for clinical practice.