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Efficacy of a cognitive intervention program in patients with mild cognitive impairment

Published online by Cambridge University Press:  18 February 2013

Galeno J. Rojas ,
Veronica Villar ,
Monica Iturry ,
Paula Harris ,
Cecilia M. Serrano ,
Jorge A. Herrera  and
Ricardo F. Allegri
Galeno J. Rojas*
Affiliation:
Memory Research Center, Department of Neurology, Hospital Zubizarreta (GCBA), Buenos Aires, Argentina Center of Cognitive Neurology (British Hospital), Buenos Aires, Argentina
Veronica Villar
Affiliation:
Memory Research Center, Department of Neurology, Hospital Zubizarreta (GCBA), Buenos Aires, Argentina
Monica Iturry
Affiliation:
Memory Research Center, Department of Neurology, Hospital Zubizarreta (GCBA), Buenos Aires, Argentina
Paula Harris
Affiliation:
Service of Cognitive Neurology (FLENI), Buenos Aires, Argentina
Cecilia M. Serrano
Affiliation:
Memory Research Center, Department of Neurology, Hospital Zubizarreta (GCBA), Buenos Aires, Argentina
Jorge A. Herrera
Affiliation:
Neurobehavioral Institute of Miami, Miami, USA
Ricardo F. Allegri
Affiliation:
Memory Research Center, Department of Neurology, Hospital Zubizarreta (GCBA), Buenos Aires, Argentina Service of Cognitive Neurology (FLENI), Buenos Aires, Argentina
*
Correspondence should be addressed to: Galeno J. Rojas, MD, Department of Neurology, Hospital Británico de Buenos Aires, Perdriel 74 – CP 1280AEB, Ciudad Autónoma de Buenos Aires, Argentina. Phone: +(54) 11 4309-6400; int. 2631. Email: [email protected].
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Abstract

Background: Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia. Identifying this condition would allow early interventions that may reduce the rate of progression to Alzheimer's disease (AD). We examined the efficacy of a six-month cognitive intervention program (CIP) in patients with MCI and to assess patients’ condition at one-year follow-up.

Methods: Forty-six MCI participants assessed with neuropsychological, neurological, neuropsychiatry, and functional procedures were included in this study and followed up during a year. The sample was randomized into two subgroups: 24 participants (the “trained group”) underwent the CIP during six months while 22 (control group) received no treatment. Sixteen participants dropped out of the study. The intervention focused on teaching cognitive strategies, cognitive training, and use of external aids, in sessions of two hours, twice per week for six months. Cognitive and functional measures were used as primary outcome and all were followed up at one year.

Results: The intervention effect (mean change from baseline) was significant (p < 0.05) on the Mini-Mental State Examination (1.74), the Clinical Dementia Rating Scale (0.14), the Boston Naming Test (2.92), block design (−13.66), matrix reasoning (−3.07), and semantic fluency (−3.071) tasks. Four patients (one trained and three controls) progressed to dementia after one year of follow-up.

Conclusions: These results suggest that persons with MCI can improve their performance on cognitive and functional measures when provided with early cognitive training and it could persist in a long-term follow-up.

Keywords

cognitive trainingcognitive strategiescognitive interventioncontrolled trialplacebomild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 5 , May 2013 , pp. 825 - 831
Copyright
Copyright © International Psychogeriatric Association 2013

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References

Allegri, R. F., Mangone, C., Villavicencio, A. F., Rymberg, S., Taragano, F. E. and Baumann, D. (1997 ). Spanish Boston Naming Test norms. The Clinical Neuropsychologist, 11, 416–420.CrossRefGoogle Scholar
Allegri, R. F.et al. (1999). El “Mini Mental State Examination” en la Argentina: instrucciones para su administración. Revista Neurológica Argentina, 24, 31–35.Google Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Belleville, S. (2008). Cognitive training for persons with mild cognitive impairment. International Psychogeriatrics, 20, 57–66.CrossRefGoogle ScholarPubMed
Belleville, S., Gilbert, B., Fontaine, F., Gagnon, L., Ménard, E. and 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, 486–499.CrossRefGoogle ScholarPubMed
Belleville, S., Chetrkow, H. and Gauthier, S. (2007). Working memory and control of attention in person with Alzheimer's disease and mild cognitive impairment. Neuropsychology, 21, 456–469.CrossRefGoogle ScholarPubMed
Birks, J. and Flicker, L. (2006). Donepezil for mild cognitive impairment. Cochrane Database of Systematic Reviews, 3, CD006104. doi:10.1002/14651858.CD006104.Google Scholar
Butman, J., Allegri, R. F., Harris, P. and Drake, M. (2000). Fluencia verbal en español. Datos normativos en Argentina. Medicina (Bs. As.), 60, 561–564.Google Scholar
Chertkow, H., Massoud, F., Nasreddine, Z., Belleville, S., Joanette, Y. and Bocti, C. (2008). Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia. Canadian Medical Association Journal, 178, 1273–1285.CrossRefGoogle ScholarPubMed
Clare, L., Woods, , Moniz, R. T., Cook, E. D., Orrell, M. and Spector, A. (2003). Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews, 4, CD003260. doi:10.1002/14651858.CD003260.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Demey, I. and Allegri, R. F. (2010). Cognitive intervention in mild cognitive impairment. A review. Vertex, 21, 253–259.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Gates, N. J., Sachdev, P. S., Fiatarone Singh, M. A. and Valenzuela, M. (2011). Cognitive and memory training in adults at risk of dementia: a systematic review. BMC Geriatrics, 11, 55.CrossRefGoogle ScholarPubMed
Harris, P., Drake, M. and Allegri, R. F. (2001). Deterioro Cognitivo leve: en búsqueda de la predemencia. Acta Psiquiátrica y Psicológica de América Latina, 47, 11–20.Google Scholar
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new clinical rating scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Hultsch, D. F., Hertzog, C. and Dixon, R. A. (1987). Age differences in metamemory: resolving the inconsistencies. Canadian Journal of Psychology, 41, 193–208.CrossRefGoogle ScholarPubMed
Jean, L., Bergeron, M. E., Thivierge, S. and Simard, M. (2010). Cognitive intervention programs for individuals with mild cognitive impairment: systematic review of the literature. American Journal of Geriatric Psychiatry, 18, 281–296.CrossRefGoogle ScholarPubMed
Kaplan, E. F., Goodglass, H. and Weintraub, S. (1983). The Boston Naming Test, 2nd edn.Philadelphia, PA: Lea and Febiger.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Loy, C. and Schneider, L. (2006). Galantamine for Alzheimer's disease and mild cognitive impairment. Cochrane Database of Systematic Reviews, 25, CD001747. doi:10.1002/14651858.CD001747.pub3.Google Scholar
Machnicki, G.et al. (2009). Validity and reliability of the SF-36 administered to caregivers of patients with Alzheimer's disease: evidence from a South American sample. Dementia and Geriatric Cognitive Disorders, 28, 206–212.CrossRefGoogle ScholarPubMed
Martin, M., Clare, L., Altgassen, A. M., Cameron, M. H. and Zehnder, F. (2011). Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane Database of Systematic Reviews, 1, CD006220. doi:10.1002/14651858.CD006220.pub2.Google Scholar
Petersen, R. C. (2002). Mild cognitive impairment: transition from aging to Alzheimer's disease. In Iqbal, K., Sisodia, S. S. and Winblad, B. (eds.), Alzheimer's Disease: Advances in Etiology, Pathogenesis and Therapeutics (pp. 141–151). Chichester, UK: John Wiley.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1958). Validity of the Trail Making Test as an indication of organic brain damage. Perceptual & Motor Skills, 8, 271–276.CrossRefGoogle Scholar
Serrano, C. M., Taragano, F., Allegri, R. F., Krupitzki, H., Martelli, M. and Feldman, M. (2007). Factores predictores de conversión en deterioro cognitivo leve. Revista Neurológica Argentina, 32, 75–93.Google Scholar
Signoret, J. L. and Whiteley, A. (1979). Memory battery scale. International Neuropsychological Society Bulletin, 2–26.Google Scholar
Springer, M. V., McIntosh, A. R., Winocur, G. and Grady, C. L. (2005). The relation between brain activity during memory tasks and years of education in young and older adults. Neuropsychology, 19, 181–92.CrossRefGoogle ScholarPubMed
Verhaeghen, P., Marcoen, A. and Goossens, L. (1992). Improving memory performance in the aged through mnemonic training: a meta-analytic study. Psychology and Aging, 72, 242–251CrossRefGoogle Scholar
Wechsler, D. (1997). WAIS III Administration and Scoring Manual. Texas: The Psychological Corporation.Google Scholar
Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence (WASI). Texas: The Psychological Corporation.Google Scholar