| ObjectiveWith the continuous acceleration of aging process,health problems of the elderly have become increasingly prominent,and a series of problems caused by the cognitive decline of the elderly have become serious public health problems.Cognition is composed of multiple dimensions:visual space,attention,language,multiple executive functions,delayed recall and orientation.Each dimension complements and cooperates with each other.The decline of cognit ive function to a certain degree will develop into dementia,which will cause a heavy economic and mental burden on society and families.Dementia is a progressive and irreversible disease.It has not been completely cured so far,so the key to prevention is early prevention and intervention.In the process of cognitive function,especially the gradual decline of memory and attention,it is often accompanied by the appearance of depressive symptoms,which has a major impact on personal health and daily life.Therefore,this study proposes the following objectives:① Design a comprehensive cognitive training program for multi-domain cognitive function;② Evaluate the effects of cognitive training on six cognitive dimensions(visual space,attention,language,multiple executive functions,delayed recall,orientation)for the elderly;③Compare the effects of cognitive training,physical intervention and the combination of the two on the overall and multidimensional cognitive function of the elderly.MethodFirst,on the basis of consulting domestic and foreign books and literature related to cognitive intervention,the intervention plan was initially sorted out.After several rounds of brainstorming by experts and teachers of the research group,the specific content of the cognitive training plan and physical intervention plan was determined.Among them,cognitive training included 26 items such as Tangrams and Chinese knots,and Baduanjin was selected for physical intervention.Secondly,we typically selected four age-adapted communities in Xiamen.After the baseline cognitive level assessment,the elderly was voluntarily recruited to participate in the intervention project.One community was selected as a blank control,and cognitive training,physical intervention and joint intervention were conducted in the remaining communities.Cognitive training group and physical intervention group were respectively trained for 12 weeks of cognitive training and Baduanjin exercises,with a frequency of 45 minutes once a week;for the joint intervention group,12 weeks of cognitive training were simultaneously carried out cognitive training courses and Baduanjin exercise,twice a week with once cognitive training and once Baduanjin exercises.45 minutes each time.The Montreal Cognitive Assessment Scale was used to assess overall and multidimensional cognitive function.Several times of follow-up were conducted at immediately,six months and twelve months after the intervention.At the baseline level,the Mann-Whitney U rank sum test was used to compare the differences in overall and multidimensional cognitive function between different intervention groups and blank control groups.With the age,education level and follow-up time controlled,the amount of change in the score from the baseline level was included as dependent variables respectively in the generalized estimation equation to assess the effects of three interventions on overall and different dimensions of cognitive function.ResultsA total of 86 subjects were included in this study.The number of participants in cognitive training group,physical intervention group,joint intervention group and control group were 21,18,25 and 22,respectively.At baseline,there was no statistically significant difference in overall and multidimensional cognitive function between different intervention groups and control group(P>0.05),indicating that three intervention groups and the control group were comparable.In different observation periods,there are certain differences in the correlations between the overall cognition and different cognitive dimensions.The results of the generalized estimation equation showed that changes in the total MoCA scores of three intervention groups are significantly higher than control group,and the joint intervention group has the largest change(β=1.18,P<0.001).Cognitive training has a significant effect on improving attention(β=0.54,P<0.05)and joint intervention can significantly improve the elderly’s visual space(β=0.85,P<0.05),language(β=1.69,P<0.05)and orientation(β=1.62,P<0.05).ConclusionThe comprehensive cognitive training program designed in this study can improve the overall cognitive level of the elderly,especially the attention dimension.In addition,if you combine cognitive training with Baduanjin,the effect will be even better.Compared with cognitive training,the effects of joint intervention on visual space language and orientation are more obvious.Therefore,in order to delay the cognitive decline and improve the life quality of the elderly,actively participating in cognitive training and Baduanjin in the community can be a good way. |
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