Cognitive training, especially computer-assisted cognitive training, as a non-pharmaceutical intervention method without obvious adverse reactions, has become an important means of prevention and intervention in cognitive impairment diseases.
In order to standardize the clinical application and research of cognitive training, the Neurologists Branch of the Chinese Medical Association has formulated the "China Guidelines for Cognitive Training (2022 Edition)" and recommended corresponding cognitive training plans for different patients and the degree of cognitive impairment.
Come and learn together!cognitive training concepts and objects
cognitive intervention refers to improving cognitive function through various external intervention methods. According to the intervention method, intervention subject and treatment purpose, cognitive intervention is divided into cognitive stimulation, cognitive rehabilitation and cognitive training.
The main intervention target of cognitive stimulation is patients with mild and moderate dementia. Under the guidance of appropriately trained caregivers, patients' cognitive function is improved through group activities such as topic discussions, handmade production, and group games for several weeks.
The main intervention target of cognitive rehabilitation is patients whose daily life ability is affected by cognitive impairment. Through the collaboration between doctors and caregivers, individualized intervention methods or strategies are adopted to maintain and improve the basic functions of patients' daily life such as eating, dressing, washing and other basic functions.
cognitive training uses the tasks designed by the system to carry out difficulty adaptive training for cognitive domains such as attention, memory, and logical reasoning to improve individual cognitive functions. Cognitive training can not only improve the cognitive domain trained, but also migrate to other cognitive domains and maintain a certain period of time. The neural basis of the effectiveness of cognitive training is brain plasticity, manifested as increased gray matter density and white matter fiber integrity, improved brain area functional efficiency, enhanced brain functional network connection, and changes in dopamine receptor density. Cognitive training can be carried out for both a single cognitive domain or multiple cognitive domains , and the training effect is mobility and time-sensitive.
Suitable objects for cognitive training includes cognitive normal elderly people, patients with subjective cognitive decline, patients with mild cognitive impairment, patients with dementia, and patients with cognitive impairment associated with other diseases.
Recommended comments:
1. Cognitive training can improve cognitive multiple cognitive domains and overall cognitive function of normal elderly people (1A) .
2. Cognitive training can improve cognitive function in patients with subjective cognitive decline to varying degrees (1B) .
3. Cognitive training can improve the overall cognitive function of patients with mild cognitive impairment (1A) .
4. Cognitive training can improve cognitive function in patients with mild and moderate dementia (1B) .
5. Cognitive training can significantly improve the overall cognitive function and key cognitive domain function of patients with Parkinson's disease and multiple sclerosis .
6. Cognitive training can improve the overall cognitive function of trauma patients (1B) .
7. Cognitive training can improve the memory function of attention deficit hyperactivity disorder children with (2B) .
8. Cognitive training can improve psychiatric symptoms and cognitive function in patients with major depression and schizophrenia (2B) .
9. Cognitive training can improve the overall cognitive function and self-management ability of elderly patients with diabetes .
Cognitive training method
cognitive training method covers multiple cognitive domains, and the training effects between different cognitive domains will migrate. Therefore, multi-cognitive domain training is more widely used in the formulation of cognitive training schemes. In addition, the continuous development and maturity of virtual reality technology and artificial intelligence technology have made the non-pharmaceutical intervention methods of cognitive training more abundant, which will help improve the effectiveness of cognitive training in patients.
Recommended comments:
1. It is recommended to use cognitive training covering multiple cognitive domains to improve cognitive function (1A) .
2. The cognitive training program should be individually designed for the cognitive domain of disease characteristics and damage (1B) .
3. It is recommended to apply virtual reality technology to cognitive training in patients with cognitive impairment (1B) .
4. Considering individual differences, other training forms such as artificial intelligence assistive technology can be combined with further improvement of training effects (1B) .
5. Cognitive training can be combined with aerobic training, non-invasive neuroregulatory technologies (such as transcranial magnetic stimulation and transcranial direct current stimulation), and improve the cognitive function of cognitively normal elderly people, patients with Alzheimer's disease and stroke patients .
6. Cognitive training should ensure the appropriate training intensity and sufficient training volume. It is recommended that each training time is not less than 30 minutes, no less than 3 times a week, and the total time for continuous training is not less than 20h (1A) .
efficacy evaluation and monitoring
Recommended opinions:
1. Objective and appropriate methods such as neuropsychological assessment and neuroplasticity indicators should be used to comprehensively evaluate the effect and migration effect of cognitive training (1C).
2. Information technology and other means should be used to monitor the completion of cognitive training efficiently and in real time (1C).
Cognitive Training Center Settings
Recommended comments:
By setting up a cognitive training center, it can effectively improve the effect of cognitive training. The cognitive training center should be equipped with qualified specialist , neuropsychological assessors, cognitive rehabilitators and nursing staff, to formulate individualized cognitive function training plans for patients, and realize the "center-community-home" integrated disease management model (1C) .
Faced with the major challenge of cognitive impairment disease, a major challenge in China's aging society, cognitive training provides an effective intervention method that can be widely used from the early stage of the disease course without obvious adverse reactions. This guide covers the applicable populations of cognitive training, training methods, effect monitoring, and disease management models. In the future, it is necessary to continuously improve the intervention level of cognitive training based on the development of disciplines such as cognitive neuroscience and artificial intelligence; at the same time, further study on the effectiveness and mechanism of cognitive training in cognitive impairment associated with different diseases.
Yimaitong compiled from: Neurologists Branch of the Chinese Medical Association, China Guide for Cognitive Training China Guide for Cognitive Training (2022 Edition) [J]. Chinese Journal of Medical Sciences , 2022, 102(37): 2918-2925. DOI: 10.3760/cma.j.cn112137-20220606-01256.
