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Cognitive Rehabilitation Multi-family Group Intervention for Individuals with Mild Cognitive Impairment and Their Care-Partners

Published online by Cambridge University Press:  15 September 2014

Maureen Schmitter-Edgecombe*
Affiliation:
Department of Psychology, Washington State University, Pullman, Washington
Dennis G. Dyck
Affiliation:
Department of Psychology, Washington State University, Spokane, Washington
*
Correspondence and reprint requests to: Maureen Schmitter-Edgecombe, Department of Psychology, Washington State University, P.O. Box 644820, Pullman, WA 99164-4820. e-mail: [email protected]

Abstract

There is increasing need for early, pro-active programs that can delay dementia diagnosis and enhance well-being of individuals with mild cognitive impairment (MCI) and their care-partners (i.e., care-dyads). This randomized controlled trial evaluated the efficacy of a combined cognitive rehabilitation and multi-family group treatment (CR-MFG) that was designed to facilitate adoption of newly learned cognitive strategies into the care-dyads everyday lives. Analyzed data included 23 care-dyads who participated in CR-MFG treatment and 23 care-dyads in standard care (SC). The 3-month intervention consisted of individual joining sessions, an educational workshop, and 20/twice weekly multifamily memory strategy training and problem-solving sessions. Everyday functioning, memory, and psychological functioning (i.e., quality-of-life, depression, coping) were assessed. The CR-MFG intervention was associated with significant post-test group differences and improved post-test performances by the MCI participants on performance-based measures of everyday functioning and neuropsychological tests of memory. There was also some suggestion that CR-MFG care-partners perceived positive change in the everyday functioning of the MCI participants. In contrast, no post-test group differences were found for either care-dyad member on the self-report psychological measures; care-partners in the treatment group did self-report improved coping behaviors at post-test. These 3-month results are preliminary but suggestive that CR-MFG may produce modest, practical everyday functional benefits for persons with MCI. (JINS, 2014, 20, 1–12)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2014 

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References

Albert, M.S., DeKosky, S.T., Dickson, D., Dubois, B., Feldman, H.H., Fox, N.C., & Phelps, C.H. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the national institute on aging-Alzheimer’s association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7(3), 270279.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4th edition, text revision. Washington, DC: American Psychiatric Press.Google Scholar
Baum, C.M., Connor, L.T., Morrison, T., Hahn, M., Dromerick, A.W., & Edwards, D.F. (2008). Reliability, validity, and clinical utility of the executive function performance test: A measure of executive function in a sample of people with stroke. American Journal of Occupational Therapy, 62(4), 446455.CrossRefGoogle Scholar
Baum, C., Morrison, T., Hahn, M., & Edwards, D. (2007). Test manual for executive function performance test. Missouri: Washington University School of Medicine.Google Scholar
Belleville, S., Clément, F., Mellah, S., Gilbert, B., Fontaine, F., & Gauthier, S. (2011). Training-related brain plasticity in subjects at risk of developing Alzheimer’s disease. Brain, 134(6), 16231634.CrossRefGoogle ScholarPubMed
Belleville, S., Gilbert, B., Fontaine, F., Gagnon, L., Ménard, É., & Gauthier, S. (2006). Improvement of episodic memory in persons with mild cognitive impairment and healthy older adults: Evidence from a cognitive intervention program. Dementia and Geriatric Cognitive Disorders, 22(5-6), 486499.Google Scholar
Blieszner, R., & Roberto, K.A. (2010). Care partner responses to the onset of mild cognitive impairment. The Gerontologist, 50(1), 1122.CrossRefGoogle Scholar
Brandt, J., Spencer, M., & Folstein, M. (1988). The telephone interview for cognitive status. Neuropsychiatry, Neuropsychology, & Behavioral Neurology, 1(2), 111117.Google Scholar
Chesney, M.A., Neilands, T.B., Chambers, D.B., Taylor, J.M., & Folkman, S. (2006). A validity and reliability study of the coping self-efficacy scale. British Journal of Health Psychology, 11(3), 421437.CrossRefGoogle ScholarPubMed
Dyck, D.G., Hendryx, M.S., Short, R.A., Voss, W.D., & McFarlane, W.R. (2002). Service use among patients with schizophrenia in psychoeducational multiple-family group treatment. Psychiatric Services, 53(6), 749754.Google Scholar
Galasko, D., Bennett, D.A., Sano, M., Marson, D., Kaye, J., & Edland, S.D. (2006). ADCS prevention instrument project: Assessment of instrumental activities of daily living for community-dwelling elderly individuals in dementia prevention clinical trials. Alzheimer Disease and Associated Disorders, 20, S152S169.CrossRefGoogle ScholarPubMed
Garand, L., Dew, M.A., Eazor, L.R., DeKosky, S.T., & Reynolds, C.F. (2005). Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment. International Journal of Geriatric Psychiatry, 20, 512522.Google Scholar
Greenaway, M.C., Duncan, N.L., & Smith, G.E. (2013). The memory support system for mild cognitive impairment: Randomized trial of a cognitive rehabilitation intervention. International Journal of Geriatric Psychiatry, 28(4), 402409.CrossRefGoogle ScholarPubMed
Greenaway, M.C., Hanna, S.M., Lepore, S.W., & Smith, G.E. (2008). A behavioral rehabilitation intervention for amnestic mild cognitive impairment. American Journal of Alzheimer’s Disease and Other Dementias, 23(5), 451461.CrossRefGoogle ScholarPubMed
Hampstead, B.M., Gillis, M.M., & Stringer, A.Y. (2014). Cognitive rehabilitation of memory for mild cognitive impairment: A methodological review and model for future research. Journal of the International Neuropsychological Society, 20, 135151.CrossRefGoogle ScholarPubMed
Holdnack, H. (2001). Wechsler test of adult reading: WTAR. San Antonio: The Psychological Corporation.Google Scholar
Huckans, M., Hutson, L., Twamley, E., Jak, A., Kaye, J., & Storzbach, D. (2013). Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults: Working toward a theoretical model and evidence-based interventions. Neuropsychology Review, 23(1), 6380.Google Scholar
Kinsella, G.J., Mullaly, E., Rand, E., Ong, B., Burton, C., Price, S., & Storey, E. (2009). Early intervention for mild cognitive impairment: A randomised controlled trial. Journal of Neurology, Neurosurgery, & Psychiatry, 80(7), 730736.Google Scholar
Kurz, A., Pohl, C., Ramsenthaler, M., & Sorg, C. (2009). Cognitive rehabilitation in patients with mild cognitive impairment. International Journal of Geriatric Psychiatry, 24(2), 163168.Google Scholar
Logsdon, R.G., Gibbons, L.E., McCurry, S.M., & Teri, L. (1999). Quality of life in alzheimer’s disease: Patient and caregiver reports. Journal of Mental Health and Aging, 5(1), 2132.Google Scholar
Lubinsky, T., Rich, J.B., & Anderson, N.D. (2009). Errorless learning and elaborative self- generation in healthy older adults and individuals with amnestic mild cognitive impairment: Mnemonic benefits and mechanisms. Journal of the International Neuropsychological Society, 15(5), 704716.Google Scholar
Marziali, S., & Garcia, L.J. (2011). Dementia caregivers; responses to 2 internet-based intervention programs. American Journal of Alzheimer’s Disease & Other Dementias, 26, 3643.Google Scholar
McFarlane, W.R., Link, B., Dushay, R., Marchal, J., & Crilly, J. (1995). Psychoeducational multiple family groups: Four-year relapse outcome in schizophrenia. Family Process, 34(2), 127144.Google Scholar
McFarlane, W.R. (2002). Multifamily groups in the treatment of severe psychiatric disorders. New York, NY: Guilford Press.Google Scholar
Mitchell, A.J., & Shiri-Feshki, M. (2009). Rate of progression of mild cognitive impairment to dementia – meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavia, 119(4), 252265.CrossRefGoogle ScholarPubMed
Morris, J.C. (1993). The clinical dementia rating (CDR): Current version and scoring rules. Neurology, 43(11), 24122414.Google Scholar
Patterson, T.L., Lacro, J., McKibbin, C.L., Moscona, S., Hughs, T., & Jeste, D.V. (2002). Medication management ability assessment: Results from a performance-based measure in older outpatients with schizophrenia. Journal of Clinical Psychopharmacology, 22(1), 1119.Google Scholar
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56, 303308.Google Scholar
Randolph, C. (1998). RBANS manual. San Antonio, TX: The Psychological Corporation.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 of Clinical and Experimental Neuropsychology, 20(3), 310319.Google ScholarPubMed
Rapp, S.R., Brenes, G., & Marsh, A.P. (2002). Memory enhancement training for older adults with mild cognitive impairment: A preliminary study. Aging & Mental Health, 6(1), 511.CrossRefGoogle ScholarPubMed
Rodgers, M., Strode, A., Norell, D., Short, R., Dyck, D., & Becker, B. (2007). Adapting multiple-family group treatment for brain and spinal cord injury intervention development and preliminary outcomes. American Journal of Physical Medicine and Rehabilitation, 86, 482492.Google Scholar
Schmitter-Edgecombe, M., Howard, J.T., Pavawalla, S.P., Howell, L., & Rueda, A. (2008). Multidyad memory notebook intervention for very mild dementia: A pilot study. American Journal of Alzheimer’s Disease and Other Dementias, 23(5), 477487.CrossRefGoogle ScholarPubMed
Schmitter-Edgecombe, M., Woo, E., & Greeley, D.R. (2009). Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. Neuropsychology, 23(2), 168177.Google Scholar
Schneider, L.S. (2013). Alzheimer disease pharmacologic treatment and treatment research. CONTINUUM (Minneapolis, Minnesota), 19(2), 339357.Google Scholar
Schreiber, M., & Schneider, R. (2007). Cognitive plasticity in people at risk for dementia: Optimising the testing-the-limits-approach. Aging & Mental Health, 11(1), 7581.CrossRefGoogle ScholarPubMed
Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5(1-2), 165173.Google Scholar
Simon, S.S., Yokomizo, J.E., & Bottino, C. (2012). Cognitive intervention in amnestic mild cognitive impairment: A systematic review. Neuroscience and Biobehavioral Reviews, 36(4), 11631178.Google Scholar
Smith, G.E., & Bondi, M.W. (2013). Mild cognitive impairment and dementia (Oxford Workshop Series New York, NY: Oxford University Press.Google Scholar
Sohlberg, M.M., & Mateer, C.A. (1989). Training use of compensatory memory books: A three stage behavioral approach. Journal of Clinical and Experimental Neuropsychology, 11, 871891.Google Scholar
Stott, J., & Spector, A. (2011). A review of the effectiveness of memory interventions in mild cognitive impairment (MCI). International Psychogeriatrics, 23(4), 526538.CrossRefGoogle ScholarPubMed
Teng, E., Tassniyom, K., & Lu, P.H. (2012). Reduced quality-of-life ratings in mild cognitive impairment: Analyses of subject and informant responses. The American Journal of Geriatric Psychiatry, 20(12), 10161025.Google Scholar
Troyer, A.K., Murphy, K.J., Anderson, N.D., Moscovitch, M., & Craik, F.I.M. (2008). Changing everyday memory behaviour in amnestic mild cognitive impairment: A randomised controlled trial. Neuropsychological Rehabilitation, 18(1), 6588.Google Scholar
Tsolaki, M., Kounti, F., Agogiatou, C., Poptsi, E., Bakoglidou, E., Zafeiropoulou, M., & Nikolaidou, E. (2011). Effectiveness of nonpharmacological approaches in patients with mild cognitive impairment. Neurodegenerative Disorders, 8, 138145.CrossRefGoogle ScholarPubMed
Williams, V.P., Bishop-Fitzpatrick, L., Lane, J.D., Gwyther, L.P., Ballard, E.L., Vendittelli, A.P., & Williams, R.B. (2010). Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer’s disease family caregivers. Psychosomatic Medicine, 72, 897904.CrossRefGoogle ScholarPubMed
Wilson, B. (2009). Memory rehabilitation integrating theory and practice. New York: Guilford Press.Google Scholar
Wilson, B., Cockburn, J., & Baddeley, A. (2003). The Rivermead Behavioural Memory Test. (2nd ed.). UK: Thames Valley Test Co.Google Scholar
Wilson, B., Cockburn, J., Baddeley, A.D., & Hiorns, R. (1989). The development and validation of a test battery for detecting and monitoring everyday memory problems. Journal of Clinical and Experimental Neuropsychology, 11(6), 855870.Google Scholar
Yuill, N., & Hollis, V. (2011). A systematic review of cognitive stimulation therapy for older adults with mild to moderate dementia: An occupational therapy perspective. Occupational Therapy International, 18(4), 163186.Google Scholar