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As the population ages, cognitive impairment has emerged as a major threat to both the quality of life in older adults and public health. Accurate assessment and personalized rehabilitation represent promising approaches to decelerate the progression of the disease. Recent advances in brain science and artificial intelligence have propelled the assessment and rehabilitation of cognitive impairment into an “intelligent” stage. Intelligent assessment integrates multimodal data—such as electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), speech, gait, and eye-tracking—with AI algorithms to enable earlier detection and more accurate evaluation of cognitive impairment. Intelligent rehabilitation leverages virtual reality (VR), brain–computer interfaces (BCIs), and neuromodulation to deliver personalized and immersive interventions that enhance patient adherence and treatment efficacy. Supported by national policies, China has formed a systematic framework in intelligent assessment and rehabilitation through the synergistic promotion of multiple policies, yielding representative outcomes including digital screening tools and immersive training systems. Nonetheless, critical challenges remain, including the limited capacity of current models to accommodate patient heterogeneity, the insufficient availability of high-quality rehabilitation resources in primary care, and the slow translation of research into clinical practice. Future efforts should focus on improving multimodal and cross-institutional big data platforms for rehabilitation, promoting the development of low-cost rehabilitation devices, strengthening the validation and clinical translation of research findings, and enhancing international cooperation to increase the global influence of China’s intelligent assessment and rehabilitation technologies.

, correspAuthors=Hongjun YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright © 2026 Science and Technology Foresight. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Xiang HUANG, Wenkai WANG, Liangwei YANG, Hongjun YANG, Zeng-Guang HOU), CN=ArticleExt(id=1251475912756249272, articleId=1251475911145636464, tenantId=1146029695717560320, journalId=1146032081894723586, language=CN, title=老年认知功能障碍的多模态智能评估与康复前沿技术, columnId=1148708266483446458, journalTitle=前瞻科技, columnName=综述与述评, runingTitle=null, highlight=null, articleAbstract=

随着人口老龄化加剧,认知功能障碍已成为威胁老年人生活质量和社会公共健康的重要问题。对认知功能障碍进行准确评估和个性化康复,是延缓其发展的有效手段。近年来,脑科学与人工智能的快速发展,推动了认知功能障碍评估与康复进入“智能化”阶段。在智能评估方面,基于脑电图、功能性近红外光谱、语音、步态、眼动等多模态数据,利用人工智能算法,实现了认知功能障碍的早期筛查与准确评估;在智能康复方面,通过引入虚拟现实、脑机接口、神经调控等新技术,为患者提供个性化、沉浸式的康复干预,提高了患者训练的依从性和康复效果。我国以国家战略为引领,在智能评估与康复领域通过多政策协同推进形成系统性布局,已取得多项典型成果。然而,目前该领域仍面临模型对患者异质性的适配能力不足、优质康复资源向基层下沉有限和科研成果转化滞后等挑战。未来,应进一步完善多模态、跨机构的康复大数据平台,推动低成本康复设备研发,强化成果的验证与临床落地,加强国际合作以提升我国智能评估与康复技术的国际影响。

, correspAuthors=杨闳竣, authorNote=null, correspAuthorsNote=null, copyrightStatement=版权所有 © 2026 前瞻科技编辑部, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=iQBsV7jJ50p/1U4GmiA/Cw==, magXml=hUgO4LfXCWiK43HbEw5aVg==, pdfUrl=null, pdf=aN+M0I+LCwB7MBCdrql2PA==, pdfFileSize=3238912, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=z6XFlavlPbl/I429kYc+UA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=K1ztWSoqrKUB2tfFkpuz+Q==, mapNumber=null, authorCompany=null, fund=null, authors=

黄想,硕士研究生。主要从事老年人运动与认知功能的智能评估、人工智能驱动的人机交互与智能康复、基于神经网络的生物信号建模与分析研究。发表论文2篇,授权发明专利2件。电子信箱:

杨闳竣,副研究员。中国自动化学会环境感知与保护自动化专委会委员、自适应动态规划与强化学习专委会委员、中国人工智能学会智能机器人专委会委员、《智能与机器人》期刊编委。主要从事运动和认知功能的多模态评估与智能康复系统研发、医疗机器人人机交互等研究。主持国家自然科学基金、国家重点研发计划等10余项。获PRCV 2021阿尔茨海默病分类技术挑战赛三等奖、2021年第五届“傅利叶”杯中国康复人创意大赛冠军、IJAC高被引论文奖等。发表论文50余篇,授权国内专利16件、国际专利3件。电子信箱:

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黄想,硕士研究生。主要从事老年人运动与认知功能的智能评估、人工智能驱动的人机交互与智能康复、基于神经网络的生物信号建模与分析研究。发表论文2篇,授权发明专利2件。电子信箱:

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黄想,硕士研究生。主要从事老年人运动与认知功能的智能评估、人工智能驱动的人机交互与智能康复、基于神经网络的生物信号建模与分析研究。发表论文2篇,授权发明专利2件。电子信箱:

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杨闳竣,副研究员。中国自动化学会环境感知与保护自动化专委会委员、自适应动态规划与强化学习专委会委员、中国人工智能学会智能机器人专委会委员、《智能与机器人》期刊编委。主要从事运动和认知功能的多模态评估与智能康复系统研发、医疗机器人人机交互等研究。主持国家自然科学基金、国家重点研发计划等10余项。获PRCV 2021阿尔茨海默病分类技术挑战赛三等奖、2021年第五届“傅利叶”杯中国康复人创意大赛冠军、IJAC高被引论文奖等。发表论文50余篇,授权国内专利16件、国际专利3件。电子信箱:

"}, bioImg=zT4MVfxBXP9vY4i943fvWw==, bioContent=

杨闳竣,副研究员。中国自动化学会环境感知与保护自动化专委会委员、自适应动态规划与强化学习专委会委员、中国人工智能学会智能机器人专委会委员、《智能与机器人》期刊编委。主要从事运动和认知功能的多模态评估与智能康复系统研发、医疗机器人人机交互等研究。主持国家自然科学基金、国家重点研发计划等10余项。获PRCV 2021阿尔茨海默病分类技术挑战赛三等奖、2021年第五届“傅利叶”杯中国康复人创意大赛冠军、IJAC高被引论文奖等。发表论文50余篇,授权国内专利16件、国际专利3件。电子信箱:

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老年认知功能障碍的多模态智能评估与康复前沿技术
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黄想 , 王文楷 1, 2 , 杨梁炜 1, 2 , 杨闳竣 , 侯增广 1, 2
前瞻科技 | 综述与述评 2026,5(1): 74-85
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前瞻科技 | 综述与述评 2026, 5(1): 74-85
老年认知功能障碍的多模态智能评估与康复前沿技术
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黄想 , 王文楷1, 2, 杨梁炜1, 2, 杨闳竣 , 侯增广1, 2
作者信息
  • 1中国科学院自动化研究所多模态人工智能系统全国重点实验室, 北京 100190
  • 2中国科学院大学人工智能学院, 北京 100049
  • 黄想,硕士研究生。主要从事老年人运动与认知功能的智能评估、人工智能驱动的人机交互与智能康复、基于神经网络的生物信号建模与分析研究。发表论文2篇,授权发明专利2件。电子信箱:

    杨闳竣,副研究员。中国自动化学会环境感知与保护自动化专委会委员、自适应动态规划与强化学习专委会委员、中国人工智能学会智能机器人专委会委员、《智能与机器人》期刊编委。主要从事运动和认知功能的多模态评估与智能康复系统研发、医疗机器人人机交互等研究。主持国家自然科学基金、国家重点研发计划等10余项。获PRCV 2021阿尔茨海默病分类技术挑战赛三等奖、2021年第五届“傅利叶”杯中国康复人创意大赛冠军、IJAC高被引论文奖等。发表论文50余篇,授权国内专利16件、国际专利3件。电子信箱:

通信作者:

Multimodal Intelligent Assessment and Rehabilitation Technologies for Cognitive Impairment in Older Adults
Xiang HUANG , Wenkai WANG1, 2, Liangwei YANG1, 2, Hongjun YANG , Zeng-Guang HOU1, 2
Affiliations
  • 1State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
  • 2School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
出版时间: 2026-03-20 doi: 10.3981/j.issn.2097-0781.20250054
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随着人口老龄化加剧,认知功能障碍已成为威胁老年人生活质量和社会公共健康的重要问题。对认知功能障碍进行准确评估和个性化康复,是延缓其发展的有效手段。近年来,脑科学与人工智能的快速发展,推动了认知功能障碍评估与康复进入“智能化”阶段。在智能评估方面,基于脑电图、功能性近红外光谱、语音、步态、眼动等多模态数据,利用人工智能算法,实现了认知功能障碍的早期筛查与准确评估;在智能康复方面,通过引入虚拟现实、脑机接口、神经调控等新技术,为患者提供个性化、沉浸式的康复干预,提高了患者训练的依从性和康复效果。我国以国家战略为引领,在智能评估与康复领域通过多政策协同推进形成系统性布局,已取得多项典型成果。然而,目前该领域仍面临模型对患者异质性的适配能力不足、优质康复资源向基层下沉有限和科研成果转化滞后等挑战。未来,应进一步完善多模态、跨机构的康复大数据平台,推动低成本康复设备研发,强化成果的验证与临床落地,加强国际合作以提升我国智能评估与康复技术的国际影响。

老年人  /  认知功能障碍  /  智能评估  /  智能康复  /  人工智能

As the population ages, cognitive impairment has emerged as a major threat to both the quality of life in older adults and public health. Accurate assessment and personalized rehabilitation represent promising approaches to decelerate the progression of the disease. Recent advances in brain science and artificial intelligence have propelled the assessment and rehabilitation of cognitive impairment into an “intelligent” stage. Intelligent assessment integrates multimodal data—such as electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), speech, gait, and eye-tracking—with AI algorithms to enable earlier detection and more accurate evaluation of cognitive impairment. Intelligent rehabilitation leverages virtual reality (VR), brain–computer interfaces (BCIs), and neuromodulation to deliver personalized and immersive interventions that enhance patient adherence and treatment efficacy. Supported by national policies, China has formed a systematic framework in intelligent assessment and rehabilitation through the synergistic promotion of multiple policies, yielding representative outcomes including digital screening tools and immersive training systems. Nonetheless, critical challenges remain, including the limited capacity of current models to accommodate patient heterogeneity, the insufficient availability of high-quality rehabilitation resources in primary care, and the slow translation of research into clinical practice. Future efforts should focus on improving multimodal and cross-institutional big data platforms for rehabilitation, promoting the development of low-cost rehabilitation devices, strengthening the validation and clinical translation of research findings, and enhancing international cooperation to increase the global influence of China’s intelligent assessment and rehabilitation technologies.

older adult  /  cognitive impairment  /  intelligent assessment  /  intelligent rehabilitation  /  artificial intelligence
黄想, 王文楷, 杨梁炜, 杨闳竣, 侯增广. 老年认知功能障碍的多模态智能评估与康复前沿技术. 前瞻科技, 2026 , 5 (1) : 74 -85 . DOI: 10.3981/j.issn.2097-0781.20250054
Xiang HUANG, Wenkai WANG, Liangwei YANG, Hongjun YANG, Zeng-Guang HOU. Multimodal Intelligent Assessment and Rehabilitation Technologies for Cognitive Impairment in Older Adults[J]. Science and Technology Foresight, 2026 , 5 (1) : 74 -85 . DOI: 10.3981/j.issn.2097-0781.20250054
认知功能障碍(Cognitive Impairment)指个体在记忆、注意力、执行功能、语言等一个或多个认知领域出现的功能性衰退,且该衰退超出正常衰老范围,足以影响日常生活能力[1]。根据功能受损程度,认知功能障碍可分为轻度认知功能障碍(MCI)和痴呆(Dementia)两类,其病因包含以阿尔茨海默病(AD)和路易体痴呆(DLB)为代表的神经退行性病变,以多发梗死及皮层下缺血损伤为核心的血管性因素,以及代谢、感染、药物和情绪障碍等可逆或继发性因素[2]。我国是世界上痴呆症患者最多的国家,患病人数约占全球痴呆症患者总数的25%,老年认知功能障碍已成为公共卫生领域的重大挑战[3]。因此,亟需引入智能化技术,以提升评估精准性和个性化康复效率。
随着脑科学、神经科学和人工智能等学科的迅速发展,认知功能障碍的早期评估与个性化干预正逐步迈向“智能化”阶段。智能评估(Intelligent Assessment)依托计算机化与数字化技术,结合机器学习方法,通过整合脑电图(EEG)、功能性近红外光谱(fNIRS)、语音、步态和眼动等多模态数据,捕捉潜在特征,实现对认知功能障碍更早期、更精细的评估[4-5]。与传统依赖纸笔量表和受试者主观反应的方式相比,智能评估不仅为制定靶向化干预方案提供了科学依据,也有助于提高治疗效果,延缓症状发展,对认知功能障碍的早期防治具有重要意义[5]
同时,智能康复(Intelligent Rehabilitation)通过引入虚拟现实/增强现实(VR/AR)、脑机接口(BCI)、计算机化认知训练(CCT)和神经调控,如经颅电刺激(tDCS)、经颅磁刺激(rTMS)等多种新兴技术,为认知功能障碍患者提供个性化、强交互可持续的干预方案。与传统康复方式相比,智能康复能够实时监测患者状态、反馈干预效果并动态调整干预参数,使训练过程具备更高的沉浸感和自适应性,提升患者的参与度和依从性[6]
鉴于人工智能在老年认知功能障碍防治中的重要潜力和临床应用需求,近年来在国家政策支持和科研推动下,逐步形成了多模态融合、跨机构协作的发展态势,并在智能评估与康复方面取得了一系列代表性成果。文章主要从智能评估和智能康复两个维度系统综述我国在该领域的发展现状和典型进展,通过国内外的发展差异对比,剖析当前领域面临的关键挑战,提出未来发展趋势和对策建议,以期为相关技术提升和临床转化提供参考。
近年来,我国通过连续性的国家五年规划,层层推进智能评估与康复领域的战略布局与重点部署。“十二五”期间推动建设分层级、分阶段的康复医疗服务体系。依托《“十三五”卫生与健康科技创新专项规划》,我国加强了脑科学研究在健康领域的应用,以促进人工智能与健康领域的交叉融合[7-8]。《“十四五”国家老龄事业发展和养老服务体系规划》明确提出推广智慧健康养老产品和康复辅助器具,鼓励人工智能、虚拟现实和脑机接口等新技术在认知评估与干预中的集成应用,并通过国家重点研发计划部署了多项相关科研攻关[9]
在政策体系方面,我国智能评估与康复领域的发展以国家战略为引领,通过多政策协同推进形成系统性布局。这一布局依托中国脑计划(科技创新2030—“脑科学与类脑研究”重大项目),其“一体两翼”框架整合了基础研究与转化应用:以脑认知神经原理解析为主体,以脑疾病诊治和类脑智能技术发展为两翼,并将老年认知功能障碍防治列为优先方向[10]。在此基础上,2024年由十五部门联合印发的《应对老年期痴呆国家行动计划(2024—2030年)》,标志着国家层面系统性防控体系的建立,明确提出至2030年实现痴呆防控认知普及、老年人认知功能全面筛查、规范化诊疗完善和照护服务能力提升的总体要求[11]
近年来,我国在认知功能障碍的智能评估领域取得了显著进展,尤其是在多模态数据融合和智能算法应用方面,促进了早期筛查与精准评估水平的提高。具体而言,国内众多高校、科研机构和企业投身于相关技术的研发与应用,提出专家共识,推动了筛查工具从传统量表向数字化、多模态评估范式演进,其研究覆盖了脑电图、功能性近红外光谱、磁共振成像、语音、眼动和步态等多个模态[12]
在脑电图方面,中南大学湘雅医院沈璐团队[13]基于所建立的大规模、多中心老年人队列,研究静息态EEG特征,实现了MCI与AD的有效区分,揭示了顶枕区θ功率、信号复杂度与认知功能、脑脊液标志物的显著关联。深圳市人民医院郭毅团队[14]从多模态整合的角度出发,结合EEG、影像组学和代谢组等数据,发现主观认知下降阶段EEG信号在β2和γ1频段已出现显著变化,同时EEG功能性连接也反映了认知退化的进展。清华大学鲁白团队[15]从静息态EEG信号和认知评估数据入手,提出了时空自适应编码网络,实现了基于EEG的认知功能连续量化评估,为智能化认知监测提供了创新的深度学习方法。
在功能性近红外光谱方面,香港中文大学陈瑞燕团队[16]聚焦AD前期人群,发现前额叶氧合下降可有效区分遗忘型轻度认知障碍与正常老人;同时,主观记忆抱怨组也表现出明显脑血氧降低,提出fNIRS参数作为痴呆早期无创生物标志物的潜力。上海交通大学崔东红团队[17-18]利用大样本静息态和任务态fNIRS数据,结合机器学习显著提升了主观认知衰退、MCI与正常对照的区分准确率,提出了基于前额叶功能连接的智能筛查方案。南开大学于宁波团队[19-20]面向帕金森病(PD)相关认知功能障碍,创新性引入图频分析等新算法,从fNIRS功能网络中提取敏感特征,有效识别PD患者的脑功能异常,展示了fNIRS与人工智能结合在认知功能障碍检测中的潜力(图1[20])。
除上述两类典型模态外,基于语音、眼动、步态和磁共振成像等模态的认知评估也受到了广泛关注。浙江大学徐欣团队[21]联合阿里巴巴达摩院共同研发了基于语音识别和对话式人工智能的认知筛查工具,用于老年痴呆和轻度认知功能障碍的社区筛查,提供了认知功能障碍数字化筛查的新视角。首都医科大学北京天坛医院王伊龙团队[22]利用人工智能辅助融合眼动与步态特征,在多中心脑小血管病队列中实现了对血管性认知功能障碍的中高准确度识别,其成果为建立客观数字生物标志物并开展便捷筛查提供了重要依据。北京师范大学Yang等[23]通过“北京老年脑健康促进计划”(BABRI),建立了覆盖数万例社区老年人的纵向随访数据库,融合认知行为、心理健康与多模态神经影像(如结构性磁共振成像、功能性磁共振成像)等信息,构建了符合我国人群特征的认知老化常模,并开发了社区可推广的脑健康筛查平台。
我国在老年认知功能障碍的智能康复研究中逐渐形成了由国家级科研平台、高水平高校与研究院所,以及军地医院和地方医疗网络共同参与的多中心协同格局。在这一格局下,研究成果主要集中在计算机化认知训练、虚拟现实与沉浸式干预技术、神经调控与认知康复联合路径3方面。
在计算机化认知训练方面,解放军总医院第八医学中心王蒙等[24]针对记忆门诊就诊的MCI患者开展了随机对照试验。该研究对比了不同频次和时长的计算机化认知训练方案,发现无论是每周3次30 min,还是更高频次的短时训练,均能在14周干预后显著提升简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评分,提示这一方法在临床具有可行性和疗效。在地方医院与社区合作中,岳阳市第一医院李晨曦等[25]开发了自主计算机认知训练程序,对近60名MCI患者进行为期5周的干预。结果显示干预组的MoCA和MMSE得分提升显著优于常规随访组,说明计算机化训练在社区环境中同样具备推广价值。在循证研究层面,多家护理学院与医学院团队开展了系统评价和Meta分析。例如,河北医科大学王雪梅等[26]纳入12项研究的Meta分析表明,计算机化认知训练能有效改善老年人注意力、短时记忆和延迟回忆功能;北京协和医学院朱明月等[27]则对既有系统评价进行再评价,认为其计算机认知训练对总体认知有明确益处。随着这些成果的不断积累,学术界逐步形成了共识,并最终推动了《认知功能障碍疾病非药物干预中国专家共识(2025版)》的发布,明确将计算机化认知训练列入规范化干预措施[28]
在虚拟现实和沉浸式干预技术方面,首都医科大学赵荣荣等[29]在轻度认知功能障碍人群中开展了虚拟现实干预研究,发现VR训练不仅能改善认知功能,还能在日常生活能力和睡眠质量方面带来积极影响,优于传统的康复手段。首都体育学院昌思琴等[30]利用神经影像学方法,探索VR训练对脑网络连接的调节作用,提出其潜在的神经机制解释,并分析训练后相关脑区间连通性和激活模式的改变,这为VR效果的机制探讨提供了初步证据。此外,安徽医科大学毛晶等[31]在卒中后认知功能障碍患者中尝试将VR与重复经颅磁刺激联合使用,结果显示联合干预组的认知改善显著优于单一干预组,提示沉浸式康复与神经调控结合的前景。
在神经调控与认知康复联合路径方面,深圳大学陈娟等[32]开展的“重复经颅磁刺激对轻度认知障碍的干预效果”研究,对MCI患者进行rTMS干预,分析其对认知功能的改善及潜在神经机制,结果显示,rTMS可通过调节突触可塑性显著改善记忆、注意力和执行功能等认知域,并对脑网络连接性产生可测的影响。该研究在技术机制上有较强探讨,也推动了联合路径设计。与此同时,国家康复辅具研究中心李增勇团队[33]探究fNIRS与神经调控(如经颅磁刺激、经颅电刺激等)结合的优势,指出这种结合方法可能促进中枢神经重组和功能恢复,并提出整合评估、反馈和干预的闭环策略,为个体化精准神经康复提供理论依据和方法支持。在经颅直流电刺激方面,中国医科大学刘员辰等[34]探索了tDCS对卒中后患者的作用,研究发现,对前额叶区域进行低强度刺激可以改善注意力和执行功能,而且耐受性较好。这些研究表明,国内的神经调控康复工作已逐渐由单一技术走向与认知训练和药物干预结合的综合路径。
综上所述,我国在老年认知功能障碍的智能康复研究呈现出多中心、多学科并行推进的格局,并逐渐形成从研究到指南、从共识到实践的完整链条。通过专家共识、系统综述和记忆门诊扩容等措施,研究成果正在不断转化为临床与社区实践,逐步构建了老年认知障碍智能康复的国内研究版图。
在老龄化加速的大背景下,认知功能障碍的智能评估已成为学界和临床共同关注的热点。近年来,国内外在政策引导、学术科研、落地实践等方面均取得进展,但路径和重点有所差异。总体来看,我国的特点是政策驱动下的快速扩张和技术创新,国外则依托成熟的临床大队列和标准化体系实现稳步发展。
在政策体系方面,我国的战略部署尤为突出。2024年发布的《应对老年期痴呆国家行动计划(2024—2030年)》明确提出,到2030年实现老年人认知功能全面筛查与规范化诊疗,强调覆盖率和规模化推广[11]。相较之下,国际社会更早建立系统性框架。世界卫生组织在2017年启动《全球应对痴呆公共卫生行动计划》(GAP),并将实施期限延长至2031年[35];美国则通过《国家阿尔茨海默病计划法案》(NAPA),在国家层面推动研究、诊疗与照护体系建设,同时结合《平价医疗法案》,将认知功能评估纳入美国联邦医疗保险(Medicare)年度健康体检,使筛查在基层实现制度化[36]。总体来看,我国更侧重普及和覆盖率,国际方面则更强调体系规范化。
在学术科研方面,我国智能评估研究正处在快速发展阶段。在科技创新2030—“脑科学与类脑研究”重大项目的持续支持下,国内团队在人工智能算法、语音分析、可穿戴设备和多模态融合等方向不断产出高水平成果,学术影响力逐渐提升。然而,多数研究仍以探索性和单中心为主,样本量有限,研究结果的普适性和临床转化度有待提高;而国际上依托长期积累的大型队列和跨机构合作,已形成了较为成熟的科研与转化模式。加利福尼亚大学旧金山分校(UCSF)、Mayo Clinic等机构不仅在多模态智能评估方面持续探索,还通过构建标准化工具和开展医生培训,将科研成果高效转化为临床实践,这有助于提升研究成果的转化效率[37-38]
在落地与普及方面,我国正推进老年痴呆筛查−诊疗−康复综合体系的建立。截至2023年,全国认知中心地图已覆盖全国31个省市的602家机构,部分城市将社区记忆门诊标准化建设纳入任务,实现筛查前移至基层和社区[11,39]。国际上则更注重流程化,UCSF推出的Dementia Care Aware项目为医疗团队提供了包括认知健康评估在内的数字化筛查工具,配合线上培训,支持基层医生在年度健康体检中嵌入认知功能评估[37]。与此同时,UCSF开发的TabCAT平板端评估系统已经在多家初级诊所进行部署,并集成至电子健康记录系统,以帮助早期识别认知功能障碍情况。
综合来看,我国的优势在于政策驱动的规模化扩张、设备的快速迭代和科研成果的提升,但在大样本、多中心验证和与国际科研合作等方面仍处于完善阶段。国际的优势在于政策和监管体系成熟、产品验证严格、长期队列研究的支撑,使智能评估在临床实现常态化。从整体格局看,当前国内外在智能评估体系建设上呈现出“规范成熟”与“技术扩展”并行的发展态势。
智能康复作为融合医学、工程与人工智能的新兴领域,正日益成为全球老龄化社会应对康复需求的重要支撑力量。国际方面,智能康复研究呈现出多维度、多层次的发展态势。首先,从硬件设备来看,康复机器人、外骨骼系统和可穿戴传感器被广泛应用于运动和认知功能训练,能够实现多样化的干预;从虚拟平台来看,基于VR/AR的沉浸式训练环境为患者提供了高度交互的康复体验,不仅提高依从性,还支持针对日常生活能力的综合训练;在场景拓展方面,远程康复和数字化康复平台使患者能够在家庭中接受个性化训练,并与临床医生保持实时连接,形成“医院−社区−家庭”康复模式。国外研究还强调通过多模态数据(如步态、脑电和肌电信号)的融合和算法优化,实现康复进展的动态监测和疗效预测,从而提高康复训练的效果。
与国外相比,我国智能康复的发展虽起步相对较晚,但近年来政策支持力度空前,技术研发和应用示范快速推进,尤其在面向社区和家庭场景的可穿戴康复设备、机器人辅助康复方面,展现出广阔的应用前景和创新能力。近年来,一系列国产康复机器人(如VR训练装置、上肢训练平台)已进入临床应用,并在社区康复中心和家庭场景中进行推广试点。部分企业和研究团队结合可穿戴设备与手机应用程序,开发了低成本、便携化的康复训练系统,便于患者在日常生活中持续接受干预,尤其适合老龄化背景下的大规模需求,未来有必要进一步推动我国康复训练系统规范化和规模化应用。
此外,从人才与学术生态角度看,国外形成了跨学科、长期稳定的研究团队和国际合作网络,而我国在高水平科研团队的持续建设和跨学科协同方面仍有提升空间。从产业化角度看,国外在康复器械标准、临床适配规范和监管体系上更为完善,形成了从科研到临床再到市场的闭环,保证了技术创新能够稳定落地。我国虽然政策和市场推动力强,但相关标准体系和监管机制仍在建设中,导致部分智能康复产品存在重复开发或落地缓慢的现象。
综合来看,当前全球智能康复领域已形成差异化发展格局,国外凭借成熟的科研积累、完善的产业化体系,在技术应用和临床落地方面处于领先地位,其科研经验、数据积累和产业化能力,为我国提供了宝贵借鉴。而我国智能康复领域依托强有力的政策支持、广阔的应用场景和巨大的市场潜力,已在部分细分领域实现突破并逐步推广,形成了自身的发展特色,但同时也面临着科研协同不足和标准体系不完善等现实问题,与国外成熟发展水平仍存在一定差距。
我国老年认知功能障碍智能评估与康复已由前期布局阶段进入技术体系深化和应用拓展的关键阶段。伴随技术体系持续完善和应用边界不断拓展,深层次的挑战也逐步显现。
近年来,我国老年认知功能障碍的智能评估研究呈现多模态融合趋势。传统纸笔量表和单一指标评估存在主观性强、敏感性不足等局限,无法满足早期识别和动态监测的需求。随着人工智能、可穿戴传感器和脑机接口等技术的发展,研究逐渐转向整合脑电图、功能性近红外光谱、步态、眼动和语言等多源数据,构建多模态认知评估体系。未来,跨模态大数据与可解释性人工智能的结合将进一步提高认知功能障碍的早筛和个性化评估水平。
在康复干预方面,运动−认知互促[40-41](认知训练可增强运动功能、运动训练可促进认知康复)成为新兴研究热点。基于这一理论,国内多项研究将认知训练与身体运动相结合,探索沉浸式、多感官干预模式。虚拟现实技术也被广泛应用于此类训练,通过将记忆、执行功能和注意力等认知任务嵌入运动场景,显著提升干预参与度和效果。
在服务体系层面,研究与实践正在推动认知功能障碍康复向全流程闭环管理转型。近年来,随着数字疗法和云平台的应用,国内逐步形成“筛查−评估−干预−管理”的一体化模式。筛查环节通过手机端自评工具或社区智能设备实现快速识别;评估环节引入多模态数据和人工智能分析,提供更精准的认知功能判断;干预环节结合虚拟现实训练、游戏化数字疗法和脑机接口等新兴手段,为患者提供个性化、可持续的康复方案;管理与随访环节依托云平台和社区网络,支持长期动态监测和效果评估。该闭环模式有助于实现早发现、早干预和持续管理,为认知功能障碍的系统化防治奠定基础。
在技术体系深化与应用拓展的发展趋势下,我国老年认知功能障碍智能评估与康复领域正面临着个性化适配能力、资源区域配置、成果转化机制和国内外数据协作等多方面的挑战。
近年来,人工智能在认知评估、步态监测和脑电图分析等康复领域展现出潜力,但其算法对患者个体差异的适应性仍待加强。现有国内与国际多数人工智能模型基于单一病种或小规模样本训练,泛化能力受限,难以满足不同年龄、性别、病情类型和康复阶段的多样化需求。例如,Mahmoud等[42]对卒中患者上肢康复的系统评价发现,总体上人工智能辅助康复较传统康复存在一定优势,但不同研究间存在中度以上的异质性(整体异质性为45%,子组异质性为59.8%),这表明模型在不同条件下的适用性存在不确定性,且这种差异不仅源于算法局限,还与缺乏跨人群、跨机构的大样本数据积累和标准化有关。
从技术路径看,多模态融合仍是短板。理想的智能评估体系应结合神经心理学量表、运动学参数和脑电图等多种指标,全方位刻画患者功能状态,但目前大多数研究依然聚焦单一模态,难以全面呈现患者全貌。同时,机构间数据壁垒和隐私保护要求限制了异构数据集的构建和共享,制约了模型个性化适配。国内也在尝试构建多模态综合评估平台,将运动特征、神经电生理与心理学指标结合起来,提升早期神经退行性疾病的识别准确率。
当前,我国高端康复设备和技术资源呈现明显的中心化特征。高质量康复资源主要集中在大城市,而农村和欠发达地区康复医疗服务远远不足[43]。截至2020年,全国仅约2 700个县(区)开展了社区康复服务,覆盖率依然较低[44]。优质资源不均衡的根源在于高昂的成本与技术门槛。例如,外骨骼康复机器人的价位曾高达近100万元,现有普惠化产品价格仍在10万元以上,这些康复设备不仅造价高,而且操作需要专业培训,基层机构难以承受。
此外,基层信息化基础较薄弱,远程康复、可穿戴监测等新模式在社区医疗的渗透率很低,限制了数字化康复模式的推广。即使康复设备到位,若缺乏专业技术人员的参与,也难以保障康复疗效。总体来看,高质量康复资源分布集中、高端康复设备成本高、基层信息化基础薄弱和专业技术人员配置不足等因素相互叠加,使得优质康复服务在基层医疗体系中的普及面临较大挑战。
我国智能康复领域科研产出活跃,但“高论文、低产品”现象明显。一方面,许多科研成果停留在实验室原型或算法层面,缺乏在真实临床场景中的验证和优化,导致实际可用性不足;另一方面,当前医工结合机制不健全,医疗机构、科研单位与企业之间的合作渠道多分散、依赖临时项目,研发链条碎片化,难以形成从基础研究到产业化的完整闭环。
此外,当前标准和规范体系尚不完善,导致企业在研发方向指引较少,高风险使得投入动力不足。监管和伦理约束同样制约创新落地。例如,医疗器械审批流程冗长,脑机接口、康复机器人等涉及神经调控的新技术需要通过严格的伦理审查,这进一步拉长了研发周期。同时,患者和公众对新技术的认知不足、产品价格高昂、医保覆盖有限,均导致相关技术即便获批,也难以实现大规模应用。近年来,国内已有一些探索性举措,如国务院印发的《关于全面深化药品医疗器械监管改革促进医药产业高质量发展的意见》,提出畅通创新药和医疗器械优先检验绿色通道,对临床急需药品医疗器械实行即收即检,旨在提升审批效率,支撑高端器械科技突破和产业化推进[45]。然而,从整体来看,科研成果从实验研究到临床应用仍面临多环节衔接不足、转化周期长等问题,创新技术在医疗体系中的规模化落地仍存在较大挑战。
循证康复医学的发展离不开大规模、多中心的数据支持。然而,我国康复数据存在标准不统一、数据共享不足的问题。各医疗机构采用的评估量表和数据编码格式差异显著,缺乏统一的数据规范,致使跨机构数据难以对接和整合。相比之下,国际上在康复数据建设方面已形成基于世界卫生组织《国际功能,残疾和健康分类》框架的标准化体系。以国际脊髓损伤核心数据集(International SCI Data Sets)为代表,其内容涵盖神经功能、认知和心理评估、日常活动能力等多维度指标,能够为认知功能评估提供标准化参考[46]。尽管近年来已有部分研究机构参与多中心项目或国际共享平台,但我国在国际康复大数据合作中的参与度仍有提升空间。
针对智能评估在患者异质性适配方面的不足,应以建设多模态、跨机构共享的康复大数据平台为突破口,推动自适应算法的研发与应用。通过在国家层面汇聚不同病种、年龄、性别,以及康复阶段的多模态数据,有望进一步突破当前仍以单中心、小样本为主的局限性,从而提升模型对复杂人群的覆盖能力。在此基础上,发展结合生成模型和联邦学习等方法的自适应算法,使评估工具能够动态适配个体差异,真正实现个性化康复路径的精准制定。
为缓解康复资源的“中心化”困境,应优先推动低成本、便携式康复设备的研发,同时促进优质资源向基层延伸。在政策引导下,鼓励科研机构与企业联合开发适用于社区、家庭场景的简易型康复辅具和可穿戴设备,降低设备采购和使用门槛。与此同时,应建立分级诊疗和转诊协作机制,使三级医院通过远程康复平台和培训项目支持基层医疗机构的康复实践,确保先进设备和技术不仅“下得去”,更能“用得好”,从而逐步实现康复服务的普惠化。
面对科研成果“高产出、低转化”的困境,应完善从方法验证到临床落地的全链条加速机制,确保成果与临床需求同步对接。同时,不断优化智能康复技术的统一行业标准,为研发和监管提供明确依据。在监管层面,对具有重大临床价值的原创技术开设绿色通道,缩短临床试验和审批周期。通过机制保障打通从实验室到临床应用的关键环节,推动科研成果真正惠及患者。
针对数据国内共享与国际对接有限的现状,应扩展大范围、多中心的康复数据库并积极参与国际多中心合作网络。在国家层面制定康复数据标准,推动不同地区和机构间的数据互联互通,避免格式不统一而导致的数据隔离。同时,建立严格的隐私保护和数据安全机制,提高机构间共享的积极性。在国际层面,应主动对接全球合作项目,贡献我国大规模康复数据,提升在国际康复学界的话语权,并借助国际循证平台吸收前沿成果。通过双向互动,不仅能推动国内循证医学发展,也能将“中国方案”推广至国际舞台。
在人口老龄化持续加速的背景下,认知功能障碍已成为公共健康领域的重要议题。随着脑科学与人工智能技术的融合发展,智能评估与康复正推动认知功能障碍防治模式由传统经验主导向数据驱动转型。我国在政策引领和科研布局推动下已取得积极进展,但在个体适配能力、资源均衡配置和成果转化机制等方面仍面临挑战。未来需在技术创新与体系建设协同推进的基础上,实现更加规范、高效的智能化防治体系,为应对老龄化挑战提供更有力支撑。
  • 国家重点研发计划(2023YFC3603700)
  • 国家自然科学基金面上项目(62473364)
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doi: 10.3981/j.issn.2097-0781.20250054
  • 接收时间:2025-12-23
  • 出版时间:2026-03-20
  • 发布时间:2026-04-16
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  • 收稿日期:2025-12-23
  • 修回日期:2026-03-05
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国家重点研发计划(2023YFC3603700)
国家自然科学基金面上项目(62473364)
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    1中国科学院自动化研究所多模态人工智能系统全国重点实验室, 北京 100190
    2中国科学院大学人工智能学院, 北京 100049

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表12种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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