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Comparison of neuropsychological and functional outcomes in Alzheimer's disease patients with good or bad response to a cognitive stimulation treatment: a retrospective analysis

Published online by Cambridge University Press:  09 August 2016

Mar Martínez-Moreno ,
Noemí Cerulla ,
Gloria Chico ,
María Quintana  and
Maite Garolera
Mar Martínez-Moreno
Affiliation:
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
Noemí Cerulla
Affiliation:
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain Sant Jordi Day Hospital for Cognitive Impairment, Consorci Sanitari de Terrassa, Barcelona, Spain
Gloria Chico
Affiliation:
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain Sant Llàtzer Day Hospital for Cognitive Impairment, Consorci Sanitari de Terrassa, Barcelona, Spain
María Quintana
Affiliation:
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain
Maite Garolera*
Affiliation:
Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain Neuropsychology Unit, Hospital de Terrassa. Consorci Sanitari de Terrassa, Barcelona, Spain Grup de Recerca Consolidat en Neuropsicologia (SGR0941), Universitat de Barcelona, Barcelona, Spain
*
Correspondence should be addressed to: Maite Garolera, PhD. Email: [email protected].
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Abstract

Background:

The benefit of cognitive stimulation (CS) treatments in dementia is unequal. This study has sought to identify cognitive and functional measurements before and after the treatment which are indicative of a better response to a one-year CS program.

Methods:

A retrospective observational study was conducted between 2004 and 2012 in a sample of 60 users diagnosed with mild Alzheimer's disease (AD) who followed a one-year CS program and underwent a cognitive and functional assessment before and after the intervention. As a primary measure of treatment response, we used the annual change of the Mini-Mental State Examination (MMSE) scores, which distinguished good responders (R) from non-responders (NR).

Results:

51.7% of patients classified as R at baseline had a higher cognitive performance in attention, immediate verbal memory, language, and working memory compared to NR. No initial statistically significant differences were found between R and NR in any sociodemographic variables, medical conditions, anxiety and/or depressive symptoms, treatment with cholinesterase inhibitors (ChEIs), level of insight, global cognitive function (MMSE), or functional capacity. After 12 months of treatment, R had significantly better results than NR on MMSE, temporal orientation, category evocation, and Philadelphia Geriatric Center-Instrumental Activities of Daily Living (PGC-IADL).

Conclusion:

The response to a CS treatment of some subjects over others is linked to cognitive and functional capacity. This research contributes to characterize the neuropsychological profile that differentiates subjects who respond better than others before and after the treatment. This should contribute to customize and optimize neuropsychological interventions in patients with AD.

Keywords

cognitive trainingdementiaAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 11 , November 2016 , pp. 1821 - 1833
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Ackerman, P. L., Beier, M. E. and Boyle, M. O. (2005). Working memory and intelligence: the same or different constructs? Psychological Bulletin, 131, 30–60. doi:10.1037/0033-2909.131.1.30.Google Scholar
Aguirre, E. et al. (2013). Cognitive stimulation therapy (CST) for people with dementia – who benefits most? International Journal of Geriatric Psychiatry, 28, 284–290. doi:10.1002/gps.3823.Google Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, 4th edn, text revision. Washington, DC: American Psychiatric Association.Google Scholar
Baddeley, A. (1992). Working memory. Science (New York, N.Y.), 255, 556–559.Google Scholar
Banerjee, S. (2012). The macroeconomics of dementia-will the world economy get Alzheimer's disease? Archives of Medical Research, 43, 705–709. doi:10.1016/j.arcmed.2012.10.006.Google Scholar
Binetti, G. et al. (2013). Predictors of comprehensive stimulation program efficacy in patients with cognitive impairment. Clinical practice recommendations. International Journal of Geriatric Psychiatry, 28, 26–33. doi:10.1002/gps.3785.CrossRefGoogle ScholarPubMed
Birks, J. (2006). Cholinesterase inhibitors for Alzheimer's disease. The Cochrane Database of Systematic Reviews, (1), CD005593. doi:10.1002/14651858.CD005593.Google ScholarPubMed
Bottini, G. et al. (2012). GOOD or BAD responder? Behavioural and neuroanatomical markers of clinical response to donepezil in dementia. Behavioural Neurology, 25, 61–72.CrossRefGoogle ScholarPubMed
Bottino, C. M. C. et al. (2005). Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: a pilot study. Clinical Rehabilitation, 19, 861–869.Google Scholar
Choi, J. and Twamley, E. W. (2013). Cognitive rehabilitation therapies for Alzheimer's disease: a review of methods to improve treatment engagement and self-efficacy. Neuropsychology Review, 23, 48–62. doi:10.1007/s11065-013-9227-4.CrossRefGoogle ScholarPubMed
Clare, L. and Woods, R. T. (2004). Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer's disease: a review. Neuropsychological Rehabilitation, 14, 385–401. doi:10.1080/09602010443000074.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: L. Erlbaum Associates.Google Scholar
Cotelli, M., Manenti, R., Zanetti, O. and Miniussi, C. (2012). Non-pharmacological intervention for memory decline. Frontiers in Human Neuroscience, 6, 46. doi:10.3389/fnhum.2012.00046.Google Scholar
Foldi, N. S., Lobosco, J. J. and Schaefer, L. A. (2002). The effect of attentional dysfunction in Alzheimer's disease: theoretical and practical implications. Seminars in Speech and Language, 23, 139–150. doi:10.1055/s-2002-24990.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Hall, L., Orrell, M., Stott, J. and Spector, A. (2013). Cognitive stimulation therapy (CST): neuropsychological mechanisms of change. International Psychogeriatrics, 25, 479–489. doi:10.1017/S1041610212001822.Google Scholar
Huntley, J. D., Gould, R. L., Liu, K., Smith, M. and Howard, R. J. (2015). Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ Open, 5, e005247. doi:10.1136/bmjopen-2014-005247.Google Scholar
Langbaum, J. B. S., Rebok, G. W., Bandeen-Roche, K. and Carlson, M. C. (2009). Predicting memory training response patterns: results from ACTIVE. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64, 14–23. doi:10.1093/geronb/gbn026.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.Google Scholar
Liberati, G., Raffone, A. and Olivetti Belardinelli, M. (2012). Cognitive reserve and its implications for rehabilitation and Alzheimer's disease. Cognitive Processing, 13, 1–12. doi: 10.1007/s10339-011-0410-3.Google Scholar
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Mak, E., Chin, R., Ng, L. T., Yeo, D. and Hameed, S. (2015). Clinical associations of anosognosia in mild cognitive impairment and Alzheimer's disease. International Journal of Geriatric Psychiatry, 30, 1207–1214. doi:10.1002/gps.4275.Google Scholar
Marshall, G. A. et al. (2011). Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7, 300–308. doi:10.1016/j.jalz.2010.04.005.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (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, 939–944.CrossRefGoogle ScholarPubMed
Onder, G. et al. (2005). Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science, 187, 450–455. doi:10.1192/bjp.187.5.450.CrossRefGoogle ScholarPubMed
Peña-Casanova, J. (2005). Programa Integrado de Exploración Neuropsicológica: Test Barcelona Revisado. Spain: Elsevier España.Google Scholar
Prince, M., Bryce, R. and Ferri, C. (2011). World Alzheimer Report 2011: The Benefits of Early Diagnosis and Intervention. London: Alzheimer's Disease International. Repéré à http://www.alz.co.uk/research/world-report-2011.Google Scholar
Randolph, C., Tierney, M. C., Mohr, E., Chase, T. N. (1998). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. Journal Clinical and Experimental Neuropsychology, 20, 310–319. doi: 10.1076/jcen.20.3.310.823.Google Scholar
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. The American Journal of Psychiatry, 139, 1136–1139. doi:10.1176/ajp.139.9.1136.Google Scholar
Saumier, D., Murtha, S., Bergman, H., Phillips, N., Whitehead, V. and Chertkow, H. (2007). Cognitive predictors of donepezil therapy response in Alzheimer disease. Dementia and Geriatric Cognitive Disorders, 24, 28–35. doi:10.1159/000102569.Google Scholar
Scarmeas, N. and Stern, Y. (2004). Cognitive reserve: implications for diagnosis and prevention of Alzheimer's disease. Current Neurology and Neuroscience Reports, 4, 374–380.Google Scholar
Sitzer, D. I., Twamley, E. W. and Jeste, D. V. (2006). Cognitive training in Alzheimer's disease: a meta-analysis of the literature. Acta Psychiatrica Scandinavica, 114, 75–90. doi:10.1111/j.1600-0447.2006. 00789.x.Google Scholar
Spector, A., Orrell, M. and Woods, B. (2010). Cognitive Stimulation Therapy (CST): effects on different areas of cognitive function for people with dementia. International Journal of Geriatric Psychiatry, 25, 1253–1258. doi :10.1002/gps.2464.Google Scholar
Wechsler, D. (2001). Wechsler Adult Intelligence Scale (WAIS-III), 3rd edn. Madrid, Spain: TEA.Google Scholar
Woods, B., Aguirre, E., Spector, A. E. and Orrell, M. (2012). Cognitive stimulation to improve cognitive functioning in people with dementia. The Cochrane Database of Systematic Reviews, 2, CD005562. doi:10.1002/14651858.CD005562.pub2.Google Scholar