计算机化认知训练对轻度认知障碍老年人干预效果的Meta分析

目的 评价计算机化认知训练对轻度认知障碍老年人的干预效果。方法 检索中英文数据库中有关计算机化认知训练对轻度认知障碍老年人干预效果的随机对照试验，应用Revman5.2软件进行Meta分析。结果 共纳入12篇文献，涉及488例病人。结果显示，干预结束时试验组简易精神状态量表（MMSE）和蒙特利尔认知功能状态量表（MoCA）得分优于对照组［MD=1.78, 95%CI(0.41，3.15), P<0.05］,［MD=4.02, 95%CI(1.33，6.70), P<0.05］；试验组顺向数字测试（DSF）和逆向数字测试（DSB）得分优于对照组［MD=1.01, 95%CI(0.39，1.64), P<0.05］,［MD=0.67, 95%CI(0.16，1.17), P<0.05］；试验组延迟回忆得分优于对照组［MD=1.20, 95%CI(1.00，1.39), P<0.05］；但对言语流畅性测试（SF）、老年抑郁量表（GDS）和日常生活能力量表（ADL）得分的改善效果不明显。结论 计算机化认知训练能改善轻度认知障碍老年人的整体认知功能, 尤其是注意力和短时记忆力以及延迟记忆能力方面，但对言语功能、抑郁状态和ADL改善效果不明显。还需大样本、高质量的随机对照试验进行验证。

Effect of computerized cognitive training in elderly with mild cognitive impairment: a meta analysis

Objective To evaluate the effect of computerized cognitive training on elderly with mild cognitive impairment.Methods A randomized controlled trial on the effect of computerized cognitive training on elderly with mild cognitive impairment was searched in Chinese and English databases, and meta analysis was performed using RevMan 5.2 software．Results A total of 12 articles were included, involving 488 patients.Meta analysis showed that the improvement of MMSE and MoCA in the intervention group was better than that in the control group after the intervention (MD=1.78, 95%CI 0.41，3.15，P<0.05; MD=4.02, 95%CI 1.33，6.70, P<0.05), the improvement of DSF and DSB in the intervention group was better than that in the control group after the intervention(MD=1.01, 95%CI 0.39，1.64, P<0.05; MD=0.67, 95%CI 0.16，1.17, P<0.05), the improvement of delay recall in the intervention group was better than that in the control group after the intervention(MD=1.20, 95%CI 1.00，1.39 , P<0.05), But, it had no obvious effect on SF, GDS and ADL. Conclusion Computerized cognitive training can improve the global cognitive function of the elderly with mild cognitive impairment, especially attention and short term memory, as well as delayed memory. But, it has no obvious effect on language abilities, depressive and everyday activities. Large sample, high quality randomized controlled study still needs more verification.