认知训练对老年痴呆患者疗效的Meta分析

Meta-analysis of the effect of cognitive training on patients with dementia

目的系统评价认知训练对老年痴呆患者的疗效。方法计算机检索PubMed、The Cochrane Library、CNKI、万方、维普数据库,搜集认知训练治疗对老年痴呆影响的相关随机对照试验(RCT),检索时限为建库至2016年9月13日。由2位研究者独立筛选文献、提取纳入文献相关资料并评价其偏倚风险。本研究采用Stata12.0软件进行Meta分析。结果共纳入6个RCT。Meta分析结果显示,相比对照组,认知训练组提高患者的日常生活能力,日常生活能力量表(ADL)标准化均数差(SMD)0.57,95%CI为0.22~0.93,P=0.002;认知训练后6个月患者精神状态仍有改善,简易精神状态检查量表(MMSE)SMD 0.56,95%CI为0.21~0.91,P=0.002;但两组在治疗后和治疗后3个月的MMSE评分差异无统计学意义(P>0.05)。结论认知训练可能有助于改善老年痴呆患者的精神状态,提高患者的日常生活能力,但对精神状态影响的远期效应更加明显。

Objective To systematically review the efficacy of cognitive training for patients with dementia. Methods PubMed, the Cochrane Library, CNKI, Wangfang, VIP Database from inception to September 13 th, 2016 were searched to collect randomized controlled trial(RCT) about cognitive training in the treatment of dementia patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software. Results A total of 6 RCTs were included. The meta-analysis yield a positive overall effect of cognitive training interventions on Activity of Daily Living Scale(ADL) after intervention(SMD=0.57, 95%CI 0.22-0.93, P=0.002). Mini-mental State Examination(MMSE) scores followed 6 months revealed that cognitive training was beneficial in patients with dementia(SMD=0.56, 95%CI 0.21-0.91, P=0.002). However, there was no difference of MMSE scores immediately after treatment and 6 months after treatment between the two groups. Conclusion Cognitive training interventions positively influence ADL and MMSE in patients with dementia, and possible long-term beneficial effects may be more apparent.