Effect Of Cognitive Training Combined With Donepezil On Patients With PSCIND

Objective:To explore the cognitive improvement of patients with post-stroke cognitive impairment no dementia(PSCIND)with cognitive training(memory training,calculation training and attention training)based on donepezil treatment.To provide effective rehabilitation treatment for non-dementia patients with cognitive impairment after stroke.Methods:Non-dementia patients with post-stroke cognitive impairment in Haiken and Jinpan communities from March 1,2022 to May 1,2022 were selected.A total of 120 patients were included according to the inclusion criteria and randomly divided into intervention group and non-intervention group,with 60 patients in each group.The non-intervention group received conventional oral administration of secondary prevention drugs for cerebral infarction(anti-platelet aggregation,lipid-regulating plaque stabilization,improving cerebrovascular circulation,controlling blood pressure and blood sugar,etc.)and donepezil.The intervention group received numeracy,memory and attention training in the community on the basis of the conventional treatment with the above drugs.The intervention group was divided into 6 groups,which were trained twice a week,with 3groups in total for 6 months.Before intervention,at 3 months and at 6 months,the Montreal Cognitive Assessment Scale(Mo CA),Simple Mental State Scale(MMSE),and General knowledge-Memory-Attention scale were used to assessed cognitive function in both groups.After the intervention,a total of 107 patients were enrolled,including 54 in the intervention group(6 cases shedding)and 53 in the non-intervention group(7 cases shedding).The cognitive scores of enrolled patients were sorted out and corresponding statistical analysis was performed.Results:1.There was no significant difference in baseline data(name,sex,age,years of education,risk factors,infarct site factors)between the two groups(P>0.05).2.Comparison results:(1)Comparison of scores before intervention:There were no significant differences between the two groups in MMSE score,Mo CA score,the total score of General knowledge-Memory-Attention and general knowledge ability,memory,attention and numeracy cognitive scores before intervention(P>0.05).(2)Score comparison at 3 months:There was no statistical significance in MMSE score and general knowledge ability score between 2 groups at 3 months(P>0.05).At 3months,Mo CA score,the total score of General knowledge-Memory-Attention,memory,attention and numeracy cognitive scores in the intervention group were higher than those in the non-intervention group,with statistical significance(P<0.05).(3)Comparison of scores at 6 months: At 6 months,the MMSE score,Mo CA score,the total score of General knowledge-Memory-Attention and the above cognitive scores of the intervention group were higher than those of the non-intervention group,with statistical significance(P<0.05).(4)Comparison of the intervention group at different time points:The MMSE score,Mo CA score,the total score of General knowledge-Memory-Attention and the above cognitive scores of the intervention group at 3 and 6 months were higher than before intervention,the differences were statistically significant(P<0.05).The total scores of General knowledge-Memory-Attention and the above cognitive scores at 6 months were higher than those at 3 months,the differences were statistically significant(P<0.05).(5)Comparison of non-intervention group at different time points: Mo CA score at 6months and MMSE score at 3 and 6 months in the non-intervention group were higher than before intervention,with statistical significance(P<0.05).There was no significant difference between the total score of General knowledge-Memory-Attention and the above cognitive scores in the non-intervention group at each time point(P>0.05).The MMSE score at 6 months and the Mo CA score at 3 months in the non-intervention group were compared with those at 3 months and before intervention,there were no statistical significance(P>0.05).3.The MMSE,Mo CA,the total of score of General knowledge-Memory-Attention of the two groups at different time points before and after the intervention were analyzed by two-factor repeated measure ANOVA,and the interaction effect between different groups and different time points was statistically significant(P<0.05).Conclusion:Cognitive training combined with donepezil improved cognition in PSCIND patients compared to donepezil alone in terms of cognitive function.It also shows the effectiveness of cognitive training on non-dementia patients with post-stroke cognitive impairment.Through a comparative study of the two groups of patients,more effective cognitive rehabilitation treatment is provided for PSCIND patients.