Background: Mild cognitive impairment (MCI) patients are at increased risk of developing dementia. There is a conflict if cognitive interventions can improve cognitive and functional performances in order to delay the development of dementia. Objectives: This study aimed to examine the effectiveness of a holistic cognitive rehabilitation program on patients with MCI. Methods: The participants, 176 MCI patients with Mini-Mental State Examination = 27.89 (1.73), were classified into 2 groups matched for age, gender, education and cognitive abilities: (1) patients (104) on nonpharmacological therapy and (2) patients (72) on no therapy at all. The effectiveness of the interventions was assessed by neuropsychological evaluation performed at baseline and at the end of the interventions. Results: Between-group difference in benefit of the experimental group was demonstrated in abilities of executive function (p = 0.004), verbal memory (p = 0.003), praxis (p ≤ 0.012), daily function (p = 0.001) and general cognitive ability (p ≤ 0.005). The experimental patients improved cognitive and functional performances, while the control patients demonstrated deterioration in daily function (p = 0.004). Conclusions: Our findings indicate that nonpharmacological therapy of the holistic approach can improve MCI patients’ cognitive and functional performances.
Montreal Cognitive Assessment (MoCA) is among the most commonly used screening tools worldwide. Objective: The aim of the study was to provide normative data for the MoCA in a Greek cohort of people older than 60 years who meet criteria for subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia in order to optimize cutoff scores for each diagnostic group. Method: Seven hundred forty-six community-dwelling older adults, visitors of the Day Center of Alzheimer Hellas were randomly chosen. Three hundred seventy-nine of them met the criteria for dementia, 245 for MCI and 122 for SCD. Results: Initial statistical analyses showed that the total MoCA score is not affected by gender ( P = .164), or age ( P = .144) but is affected by educational level ( P < .001). A cutoff score of 23 for low educational level (≤6 years) can distinguish people with SCD from MCI (sensitivity 71.4%, specificity 84.2%), while 26 is the cutoff score for middle educational level (7-12 years; sensitivity 73.2%, specificity 67.0%) and high educational level (≥13 years; sensitivity 77.6%, specificity 74.7%). Montreal Cognitive Assessment can discriminate older adults with SCD from dementia, with a cutoff score of 20 for low educational level (sensitivity 100%, specificity 92.3%) and a cutoff score 23 for middle educational level (sensitivity 97.6%, specificity 92.7%) and high educational level (sensitivity 98.5%, specificity 100%). Conclusion: Montreal Cognitive Assessment is not affected by age or gender but is affected by the educational level. The discriminant potential of MoCA between SCD and MCI is good, while the discrimination of SCD from dementia is excellent.
Objective: This study aimed to examine the effectiveness of RHEA, a cognitive training through kinetic exercises, on patients with mild cognitive impairment. Subjects and Method: Participants, completing study, were 58 mild cognitive impairment patients with MMSE ϭ 27.69, assigned to 2 groups of 29 each (experimental, 20-weekly RHEA sessions, and no-therapy control), matched for age, gender, education, cholinesterase inhibitors, cognitive abilities. Neuropsychological assessments were performed at baseline and after 5 months. Results: Between groups difference to the benefi t of the experimental group were demonstrated in attention (P ϭ .002), language (P ϭ .015), visual-spatial abilities (P ϭ .013), MMSE (P ϭ .047), and daily function (P ϭ .009). Experimental participants improved cognitive and functional performances while control participants remained stable.sent. The dropouts were mainly due to health and family problems. At the completion of the study, there were 29 patients (6 men, 23 women) in the experimental group and 29 patients (6 men, 23 women) in the control group, a total of 58 persons.
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