Efficacy And Influence Analysis Of Computer-assisted Cognitive Training In The Treatment Of Mild Alzheimer’s Disease

Background and ObjectiveAlzheimer’s disease(AD)is recognized as one of the most significant public health challenges,severely impairing the quality of life of patients and hindering the economic development of society.However,there is no effective treatment for the disease so far,and the limitation of drug therapy makes people more and more interested in non-drug therapy.Through digital electronic equipment to provide computer-aided cognitive training(CCT),is to maintain cognitive function in the elderly of health or cognitive dysfunction and social psychological function of promising strategy.But not all patients can benefit in the process of cognitive training treatment,studies have found that the result of individual differences appeared in the process of treatment in patients with AD and apolipoprotein E(ApoE)gene polymorphisms have certain correlation,but not all of ApoE epsilon4 carriers would develop AD,so as to prompt the ApoE gene type and other genetic or environmental factors such as age,cultural level,race,gender,comorbidity and other non-cognitive factors to influence the development of AD.Our aim was to investigate the cognitive effects of computer-based interventions based on ApoE genotype,age,education level,and gender.Similarly,follow-up evaluations at 3 and 6 months were conducted to determine which training program was more likely to delay further cognitive decline and dementia.We evaluated and compared the efficacy of different web-based interventions and then assessed whether the apo E genotype affected the outcome.It is expected that such findings may be useful for improving therapeutic interventions with Web-based assistive technologies in current and future studies.MethodsNinety patients diagnosed with mild AD were selected according to neuropsychological scores,and 58 of them were randomly selected as the experimental group and the remaining 32 as the control group according to the Alzheimer’s Disease Assessment Scale(ADAS-cog),MMSE and Clinical Dementia Rating Scale(CDR).The experimental group was given CCT with drug therapy(donepezil 10mg/d)and basic nursing support for 3 months,and the control group was given drug therapy(donepezil 10mg/d)and basic nursing support,and the participants’ ApoE gene polymorphism was detected.Before treatment,3 months and6 months after treatment,all participants were evaluated with a neuropsychological scale to analyze the differences in cognitive function between the experimental group and the control group before and after treatment.Factors affecting the cognitive level of the experimental group,such as ApoE gene,age,years of education,were analyzed.Results1.Compared with the control group,there was a statistically significant difference in the overall cognitive function of the experimental group after 3 months of treatment(MMSE:t=2.823,P = 0.006;ADAS-cog,t=1.997,P = 0.049).There was no statistically significant difference in the level of cognitive function observed in the experimental group at 6 months follow-up(P > 0.05).2.The results of CCT treatment in the experimental group were correlated with the years of education of patients(r=-0.561,P = 0.030).3.The results of CCT treatment in the experimental group were correlated with the ApoE ε4 gene carrier status(r=3.926,P = 0.032).4.ApoEε4 gene carrier status has a domain-specific effect on the outcome of CCT therapy.There were significant differences in AVLT delayed recall(t=-2.255,P=0.028)and BNT(t=-2.117,P=0.039)between the ApoE ε4 carrier group and the non-ApoE 4 carrier group,but no significant differences in other cognitive domains(P > 0.05).Conclusion1.Computer-assisted cognitive training can improve or delay the progression of overall cognitive dysfunction in patients with mild AD.2.Cultural level may affect the cognitive training process of patients,and influence the cognitive plasticity and neuroplasticity process to a certain extent through cognitive reserve.3.Non-carriers of the ApoE ε4 allele tended to benefit more from cognitive training than carriers,especially in delayed recall and language function,suggesting that risk genotypes may attenuate cognitive training outcomes.