The Direct Effects And Transfer Effects Of Multi-task Process Cognitive Training On Executive Function In Community-dwelling With Mild Cognitive Impairment

Research Background:Recent research from both human and animal studies confirms that cognitive training gains a notable effect on delaying cognitive decline in individuals with mild cognitive impairment.Therefore,the development and validation of cognitive training of MCI have become the focus subject of the non-pharmaceutical intervention study.At the same time,some developed countries have set it as a public health service project of primary medical institutions.However,previous studies have yet paid scant attention to specific cognitive domain-executive function training,and those effect has not yet reached a unified conclusion.Furthermore,little is known about whether this specific benefit translates to maintaining long-term effectiveness and transfer effects are.Research Purpose:1.The process model was used as a theoretical framework to initially construct a process-based multi-task cognitive training program.2.To evaluate whether the multitask-process cognitive training program would provide direct results on executive function in the community elderly with MCI.3.To explore the transfer effect of a multitask-process cognitive training program on the untrained cognitive domain functions in the community elderly with MCI.4.To explore the sustainability of multitask-process cognitive training programs on executive functionand untrained cognitive domain functions.Research Methods:This study is a randomized controlled study.From April 2018 to June 2019,the elderly with MCI in the Huzhou community of Zhejiang province were randomly selected as participants.Ninety-two participants with MCI who met the inclusion and exclusion criteria were randomly divided into the cognitive training group and the waitlist control group,with 46 cases in each group.The waitlist control group were received health education related to MCI disease,the cognitive training group added 10 weeks of a process-based multi-task cognitive training program.Besides,the waitlist control group was given process-based cognitive training after all data were collected.Respectively in three-time points of at baseline(T0),after 10 weeks of training(T1),and a 3-month follow-up(T2)to evaluate all participants with MCI'executive function and untrained cognitive domain functions(overall cognitive function,psychomotor speed and working memory)by using six instruments including the TMT A-B,Stroop color-word interference test,MoCA,reaction time,finger tapping test and digit span test.Repeated measures analysis of variance was used to verify the change of correlation indexes at different time points.Research Results:In this study,a total of 92 community participants with MCI were included.7 participants dropped out in the middle of the study,5 participants lost to follow-up and a total of 80 subjects completed the cognitive training.The compliance of the cognitive training group was 87.4%.1.Repeated measurement ANOVA shows: there were significant differences in the Trail making test A-B,Stroop color-word interference test,MoCA,reaction time,finger tapping test and Digit span test between the two groups in terms of between-group effect,time effect and group-time interaction effect(P<0.05).2.Simple effects analysis shows: compared with the wait-list control group,the multi-task cognitive training had a positive direct effect on the TMT A-B,Stroop color-word interference test and had a positive transfer effect on the MoCA,reaction time,finger tapping test and Digit span test.In addition,these improvements maintained until the end of a 3-months follow-up.Research Conclusion:This study verified the effectiveness of the multitask-process cognitive training program,that is,cognitive training could effectively improve executive function and transfer effects on the untrained cognitive domain function of the community elderly with MCI,and these improvements maintained until the end of a 3-month follow-up.Participants in community elderly with mild cognitive impairment were more likely to participate in multitask-process cognitive training programs.In addition,cognitive training has obvious effects on improving the cognitive function of MCI,which is characterized by low cost and easy implementation.Therefore,it is provide a set of standardized and procedural nursing intervention program for the cognitive management of community participants with MCI.