石义容，董新秀，胡　慧



老年轻度认知损害系统文献分析及认知康复理论模型的构建

石义容，董新秀，胡慧

摘要：[目的]通过系统文献分析，建立老年轻度认知损害(MCI)认知康复的理论模型，评价认知康复干预的效果。[方法]检索PubMed、中国知网、万方数据库、中国生物医学文献数据库2004年—2014年正式发表的MCI相关文献，利用Note Express软件和Excel建立数据库对文献内容进行分析，确立MCI认知康复的理论模型。根据纳入和排除标准，最后对21篇文献进行认知康复干预效果分析。[结果]基于设计的理论认知康复理论模型分析文献得知，文献在研究设计、认知康复干预方式、测量干预前后认知改变的工具方面各异；大量的证据表明，认知康复可以改变MCI病人个人目标行为，提高其客观认知功能，但具体提高客观认知功能的哪些反面，不同的文献说法不一；其他重要的评估方面(日常生活功能、生活质量、神经症状严重程度)很少评估研究；很少有文献评估认知康复的长期效果和认知康复对MCI向AD转化率的影响。[结论]MCI的认知康复干预效果不确定，大样本的随机对照试验、MCI认知康复的长期效果分析、认知康复具体机制分析等是证明认知康复干预有效的必要保障。

关键词：轻度认知损害；认知康复；认知训练；系统综述；痴呆

Systematic literature analysis of mild cognitive impairment and construction of cognitive rehabilitation theoretical model in elderly

Shi Yirong,Dong Xinxiu,Hu Hui

(College of Nursing,Hubei University of Chinese Medicine,Hubei 435200 China)

AbstractObjective:In order to establish the theoretical model of cognitive rehabilitation on mild cognitive impairment(MCI) in elderly and evaluate the effect of cognitive rehabilitation intervention.Methods:It retrieved the MCI related literatures officially publicated in Pub Med,CNKI,Wanfang database,Chinese biomedical literature database from 2004 to 2014.Express Note software and Excel were used to establish a database to analyze the content of the literature,and to establish the theoretical model of MCI cognitive rehabilitation.According to the inclusion and exclusion criteria,finally,21 literatures were analyzed on the intervention effect of cognitive rehabilitation.Results:The systematic literature analysis based on the theoretical model of cognitive rehabilitation showed that the literatures were different in aspects of the research design,styles of cognitive rehabilitation intervention and measurement tools of cognitive change before and after intervention.A large amount of evidences indicated that cognitive rehabilitation could change the behavior of MCI patients’ individual goals and improve their objective cognitive function.But the opposite aspects of the objective cognitive function were improved,different literatures were different.Other important aspects of assessment(daily life function,quality of life,severity of neurological symptoms)were rarely evaluated.There were fewer literatures for assessing the long-term effect of cognitive rehabilitation and the effect of cognitive rehabilitation on the conversion of MCI to AD.Conclusion:The intervention effect of cognitive rehabilitation for MCI was uncertain. They including large sample randomized controlled trials,the long-term effect analysis of MCI cognitive rehabilitation,and the analysis of the specific mechanisms of cognitive rehabilitation were proved to be an effective and necessary guarantee for cognitive rehabilitation intervention.

Key wordsmild cognitive impairment,MCI;cognitive rehabilitation;cognitive training;systematic review;dementia

老年轻度认知损害(mild cognitive impairment,MCI)是用来描述一个老年人认知障碍程度不足以诊断为痴呆，是正常衰老和痴呆之间的中间阶段和各种神经退行性疾病引起痴呆症的前驱期，包括阿尔茨海默病(AD)、额颞痴呆、路易体痴呆、血管性痴呆等[1]。……