Evaluation Of Differential Cognitive Training In Elderly Patients With Mild Cognitive Impairment In Wuhan

Objective: By observing the changes in the overall cognitive function,memory,visual space ability,attention and executive function of the elderly with mild cognitive impairment before and after the intervention,the effect of differential cognitive training could be evaluated.Ⅰt could provide a basis for formulating more scientific and reasonable cognitive training programs in the future.Methods: A total of 203 elderly people aged over 65 years old with mild cognitive impairment were included in this study.They were divided into 3 groups.There were 69 people in the control group,65 people in the intervention group Ⅰ,and 69 people in the intervention group Ⅱ.The elderly in the control group received the general health guidance,and the elderly in the group Ⅰ were 60 minutes of cognitive training once a week,and the elderly in the group Ⅱ were received 20 minutes of cognitive training 3times a week,and the total duration of the intervention was 6 months.Before the intervention,3 months and 6 months after the intervention,Cognitive assessments were performed by using Montreal cognitive assessment-basic(Mo CA-B),auditory verbal learning test(AVLT),clock drawing test(CDT),digit span test(DST)and shape trails test-B(STT-B).The repeated measures analysis of variance was used to statistically test the changes in cognitive function and evaluate the effect of differential cognitive training.Results:(1)Overall cognitive function: After 3 months of intervention,the Mo CA-B scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 1.348,95%CI: 0.289～2.406;HR: 1.781,95%CI: 0.740～2.823,P<0.05).After 6 months of intervention,the Mo CA-B scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 2.198,95%CI:0.937～3.459;HR: 2.656,95%CI: 1.416～3.897,P<0.05).After 3 and 6 months of intervention,there was no significant difference in Mo CA-B scores between intervention group Ⅱ and intervention group Ⅰ(HR: 0.433,95%CI:-0.625～1.492;HR:0.458,95%CI:-0.803～1.719,P>0.05).(2)Memory: After 3 months of intervention,the AVLT scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 6.698,95%CI: 0.151～13.245;HR: 7.250,95%CI: 0.810～13.690,P<0.05).After 6 months of intervention,the AVLT scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 8.683,95%CI: 2.558～14.808;HR: 9.531,95%CI: 3.506～15.556,P<0.05).After 3 and 6 months of intervention,there was no significant difference in AVLT scores between intervention group Ⅱ and intervention group Ⅰ(HR: 0.552,95%CI:-5.995～7.099;HR: 0.848,95%CI:-5.277～6.973,P>0.05).(3)Visual spatial ability: After 3 months of intervention,the CDT scores of intervention group Ⅰ and intervention group Ⅱ were not statistically different from those of the control group(HR: 1.098,95%CI:-1.093～3.289;HR: 1.969,95%CI:-0.187～4.124,P>0.05).After 6 months of intervention,the CDT scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 3.013,95%CI: 0.900～5.125;HR: 3.906,95%CI: 1.828～5.985,P<0.05).After 3 and 6 months of intervention,there was no significant difference in CDT scores between intervention group Ⅱ and intervention group Ⅰ(HR: 0.871,95%CI:-3.062～1.320;HR: 0.894,95%CI:-1.219～3.006,P>0.05).(4)Attention: After 3 months of intervention,the DST scores of intervention group Ⅰ and intervention group Ⅱ were not statistically different from those of the control group(HR: 1.225,95%CI:-0.252～2.702;HR: 0.906,95%CI:-0.547～2.359,P>0.05).After 6 months of intervention,the DST scores of intervention group Ⅰ and intervention group Ⅱ were higher than those of the control group,and the difference was statistically significant(HR: 2.006,95%CI: 0.558～3.454;HR: 1.563,95%CI: 0.138～2.987,P<0.05).After 3 and 6 months of intervention,there was no significant difference in DST scores between intervention group Ⅱ and intervention group Ⅰ(HR:-0.319,95%CI:-1.796～1.158;HR:-0.444,95%CI:-1.892～1.004,P>0.05).(5)Executive function: After 3 months of intervention,the STT-B time of intervention group Ⅰ and intervention group Ⅱ were not statistically different from those of the control group(HR:-1.121,95%CI:-27.782～25.540;HR: 5.094,95%CI:-21.134～31.321,P>0.05).After 6 months of intervention,the STT-B time of intervention group Ⅰ and intervention group Ⅱ were not statistically different from those of the control group(HR:-9.983,95%CI:-37.440～17.473;HR:-4.438,95%CI:-31.448～22.573,P>0.05).After 3 and 6 months of intervention,there was no significant difference in STT-B time between intervention group Ⅱ and intervention group Ⅰ(HR:6.215,95%CI:-20.447～32.876;HR: 5.546,95%CI:-31.911～33.002,P>0.05).Conclusion:(1)Differential cognitive training had a certain effect on the overall cognitive function,memory,visual space ability,and attention of the elderly with mild cognitive impairment,but the effect on the executive function was not obvious.(2)There was no statistical difference in the improvement of cognitive function between high-frequency short-duration and low-frequency long-duration cognitive training.Elderly people with mild cognitive impairment can choose appropriate cognitive training methods according to their own conditions.