![]() ![]() The mean (standard deviation ) number of sessions per patient was 4.1 (3.8). The majority of OT-guided sessions (110/137 80%) were completed. ![]() Secondary outcomes included feasibility of goal session length (20 min), participant clinical outcomes (delirium prevalence and duration, cognitive status, functional status, quality of life, and ICU length of stay), and a description of methodological challenges and solutions for future research.ResultsSeventy patients were enrolled and 69 patients were included in the final analysis. The primary outcome was feasibility of the intervention as measured by the proportion of eligible cognitive interventions delivered by the OT. Due to the COVID-19 pandemic, the study enrolment period was truncated. Patients aged ≥ 18 yr admitted to a medical/surgical ICU were randomized to the standard delirium prevention protocol or to the OT-guided cognitive intervention protocol in addition to standard of care. We assessed the feasibility of a novel occupational therapist (OT)-guided cognitive intervention protocol, titrated according to sedation level, in critically ill patients.Methods PurposeIntensive care unit (ICU) delirium is a common complication of critical illness requiring a multimodal approach to management. Researchers should describe and classify their interventions appropriately by using the available terminology. Further well-designed studies of cognitive training and cognitive rehabilitation are required to provide more definitive evidence. The results of the single RCT of cognitive rehabilitation show promise but are preliminary in nature. Trial reports indicate that some gains resulting from intervention may not be captured adequately by available standardized outcome measures. However, there is still no indication of any significant benefits from cognitive training. The available evidence regarding cognitive training remains limited, and the quality of the evidence needs to improve. The single RCT of cognitive rehabilitation found promising results in relation to some patient and caregiver outcomes and was generally of high quality. The overall quality of the trials was low to moderate. Cognitive training was not associated with positive or negative effects in relation to any of the reported outcomes. One RCT of cognitive rehabilitation was identified, allowing the examination of effect sizes, but no meta-analysis could be conducted. Overall estimates of the treatment effect were calculated by using a fixed-effects model, and statistical heterogeneity was measured by using a standard chi-squared statistic. Several outcomes were not measured in any of the studies. A large number of measures were used in the different studies, and meta-analysis could be conducted for several primary and secondary outcomes of interest. Eleven RCTs reporting cognitive training interventions were included in the review. Randomized controlled trials (RCTs), published in English, comparing cognitive rehabilitation or cognitive training interventions with control conditions and reporting relevant outcomes for the person with dementia or the family caregiver (or both), were considered for inclusion. The present review is an abridged version of a Cochrane Review and aims to systematically evaluate the evidence for these forms of intervention in people with mild Alzheimer's disease or vascular dementia. Cognitive training and cognitive rehabilitation are specific forms of non-pharmacological intervention to address cognitive and non-cognitive outcomes. Interventions that target these cognitive deficits and the associated difficulties with activities of daily living are the subject of ever-growing interest. Cognitive impairments, and particularly memory deficits, are a defining feature of the early stages of Alzheimer's disease and vascular dementia. ![]()
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