Aging Clinical and Experimental Research

, Volume 25, Issue 4, pp 421–426 | Cite as

One-year repeated cycles of cognitive training (CT) for Alzheimer’s disease

  • Susanna Bergamaschi
  • Giorgio Arcara
  • Attilio Calza
  • Daniele Villani
  • Vasiliki Orgeta
  • Sara Mondini
Original Article

Abstract

Background

Recent research suggests that a combination of both pharmacological and psychosocial treatments targeting cognitive functions improves cognition in patients with Alzheimer’s disease (AD). The present study evaluated the effectiveness of a 1-year cognitive training (CT) by comparing the cognitive performance of 16 patients with AD treated with CT and cholinesterase inhibitors (ChEIs) (experimental group) with the performance of 16 patients treated with a non-specific cognitive treatment and ChEIs (control group).

Methods

This study was a single-blind randomized controlled trial. The patients in the experimental group received pharmacological treatment and repeated cycles of CT for 1 year, whereas the control group received pharmacological treatment and repeated cycles of non-specific cognitive exercises. The patients in the two groups were administered a variety of neuropsychological tests measuring several cognitive functions (i.e. memory, language, reasoning, executive function, working memory and apraxia), activities of daily living, and depression.

Results

After 1 year of training, the experimental group scored significantly higher on the Mini Mental State Examination, the Milan Overall Dementia Assessment battery and in other five neuropsychological tests, compared to the control group.

Conclusions

Present results suggest that repeated cycles of CT in patients with AD treated with ChEIs are associated with benefits in several areas of cognitive function.

Keywords

Dementia Cognitive impairment Neuropsychological assessment Non-pharmacological interventions 

Notes

Conflict of interest

None.

References

  1. 1.
    Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sørensen P (2004) Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes 2:52PubMedCrossRefGoogle Scholar
  2. 2.
    Graff MJL, Adang EMM, Vernooij-Dassen MJM et al (2008) Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ 336:134–138PubMedCrossRefGoogle Scholar
  3. 3.
    Birks J. Cholinesterase inhibitors for Alzheimer’s disease (Cochrane Review). The Cochrane Library 2006, Issue 1. Update Software, OxfordGoogle Scholar
  4. 4.
    Hogan DB (2007) Improving drug trials for mild to moderate Alzheimer’s disease. Can J Neurol Sci 34:S97–S102PubMedGoogle Scholar
  5. 5.
    Clare L, Woods RT (2004) Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer’s disease: a review. Neuropsychol Rehabil 14:385–401CrossRefGoogle Scholar
  6. 6.
    Clare L, Woods B, Moniz Cook E, Orrell M, Spector A. Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia. The Cochrane Library 2003, Issue 4. Update Software, OxfordGoogle Scholar
  7. 7.
    De Vreese LP, Verlato C, Emiliani S et al (1998) Effect size of a three-month drug treatment in AD when combined with individual cognitive retraining: preliminary results of a pilot study. Neurobiol Aging 19:S213Google Scholar
  8. 8.
    Davis RN, Massman PJ, Doody RS (2001) Cognitive intervention in Alzheimer’s disease: a randomized placebo-controlled study. Alzheimer Dis Assoc Disord 15:1–9PubMedCrossRefGoogle Scholar
  9. 9.
    Quayhagen MP, Quayhagen M, Corbeil RR et al (2000) Coping with dementia: evaluation of four nonpharmacologic interventions. Int Psychogeriatr 12:249–265PubMedCrossRefGoogle Scholar
  10. 10.
    Camp CJ, Bird MJ, Cherry KE (2000) Retrieval strategies as a rehabilitation aid for cognitive loss in pathological aging. In: Hill RD, Bäckman L, Stigsdotter NA (eds) Cognitive rehabilitation in old age. Oxford University Press, Oxford, pp 24–248Google Scholar
  11. 11.
    Clare L, Wilson BA, Carter G, Hodges JR, Adams M (2001) Long-term maintenance of treatment gains following a cognitive rehabilitation intervention in early dementia of Alzheimer’s type: a single case study. Neuropsychol Rehabil 11:477–494CrossRefGoogle Scholar
  12. 12.
    Clare L, Wilson BA, Carter G, Roth I, Hodges JR (2002) Relearning of face-name associations in early-stage Alzheimer’s disease. Neuropsychology 16:538–547PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson J, Arens K, Johnson R, Coppens P (2001) Spaced retrieval vs memory tape therapy in memory rehabilitation for dementia of the Alzheimer’s type. Clin Gerontol 24:123–139CrossRefGoogle Scholar
  14. 14.
    Mondini S, Bergamaschi S, Baronio R, Tadioli R, Papagno C (2005) Training di attivazionecognitiva (AT) in pazienti con demenza iniziale. In: Bisiacchi P, Tressoldi P (eds) Metodologia della riabilitazione delle funzioni cognitive. Carocci Editore, Roma, pp 133–169Google Scholar
  15. 15.
    Magni E, Binetti G, Bianchetti A, Rozzini R, Trabucchi M (1996) Mini-Mental State Examination: a normative study in Italian elderly population. Eur J Neurol 3:1–5CrossRefGoogle Scholar
  16. 16.
    Brazzelli M, Capitani E, Della Sala S, Spinnler H, Zuffi M (1994) A neuropsychological instrument adding to the description of patients with suspected cortical dementia: the Milan Overall Dementia Assessment. J Neurol Neurosurg Psychiatry 57:1510–1517PubMedCrossRefGoogle Scholar
  17. 17.
    American Psychiatric Association (1994) The diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  18. 18.
    McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34:939–944PubMedCrossRefGoogle Scholar
  19. 19.
    Dubois B, Feldman HH, Jacova C et al (2007) Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 6:734–746PubMedCrossRefGoogle Scholar
  20. 20.
    Bergamaschi S, Iannizzi P, Mondini S, Mapelli D (2008) Demenza. 100 esercizi di stimolazione cognitiva. Raffaello Cortina Editore, MilanoGoogle Scholar
  21. 21.
    Mondini S, Mapelli D, Vestri A, Arcara G, Bisiacchi PS (2011) L’Esame Neuropsicologico Breve-2. Raffaello Cortina Editore, MilanoGoogle Scholar
  22. 22.
    Alexopoulos GA, Abrams RC, Young RC, Shamoian CA (1988) Cornell scale for depression in dementia. Biol Psych 23:271–284CrossRefGoogle Scholar
  23. 23.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919PubMedCrossRefGoogle Scholar
  24. 24.
    Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMedCrossRefGoogle Scholar
  25. 25.
    Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol 57:289–300Google Scholar
  26. 26.
    Benjamini Y, Yekutieli D (2001) The control of the false discovery rate in multiple testing under dependency. Ann Stat 29:1165–1188CrossRefGoogle Scholar
  27. 27.
    R Development Core Team R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2012. ISBN: 3-900051-07-0. http://www.R-project.org/
  28. 28.
    Spector A, Woods B, Orrell M (2008) Cognitive stimulation for treatment of Alzheimer’s disease. Expert Rev Neurother 8(5):751–757PubMedCrossRefGoogle Scholar
  29. 29.
    Clare L, Linden DEJ, Woods RT et al (2010) Goal-oriented cognitive rehabilitation for people with early Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. Am J Geriatric Psychiatry 18(10):928–939CrossRefGoogle Scholar
  30. 30.
    Wilson BA (2002) Towards a comprehensive model of cognitive rehabilitation. Neuropsychol Rehabil 12:97–110CrossRefGoogle Scholar
  31. 31.
    Takeda M, Tanaka T, Okochi M, Kazui H (2012) Non-pharmacological intervention for dementia patients. Psychiatry Clin Neurosci 66:1–7PubMedCrossRefGoogle Scholar
  32. 32.
    Sitzer DI, Twamley EW, Jeste DV (2006) Cognitive training in Alzheimer’s disease: a meta-analysis of the literature. Acta Psychiatr Scand 114:75–90PubMedCrossRefGoogle Scholar
  33. 33.
    Farina E, Mantovani F, Fioravanti R et al (2006) Evaluating two group programmes of cognitive training in mild-to-moderate AD: is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one? Aging Ment Health 10(3):211–218PubMedCrossRefGoogle Scholar
  34. 34.
    Loewenstein DA, Acevedo A, Czaja SJ, Duara R (2004) Cognitive rehabilitation of mildly impaired Alzheimer disease patients on cholinesterase inhibitors. Am J Geriatr Psychiatry 12:395–402PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Susanna Bergamaschi
    • 1
    • 2
  • Giorgio Arcara
    • 4
  • Attilio Calza
    • 2
  • Daniele Villani
    • 2
  • Vasiliki Orgeta
    • 3
  • Sara Mondini
    • 1
    • 2
  1. 1.Department of General PsychologyUniversity of PaduaPaduaItaly
  2. 2.Casa di Cura Figlie di San CamilloCremonaItaly
  3. 3.UCL, Mental Health Sciences UnitLondonUK
  4. 4.I.R.C.C.S. Fondazione Ospedale San CamilloVeniceItaly

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