Our aim was to study the duration of benefits derived from a neuropsychological rehabilitation program (NRP) for dementia patients. METHOD: The participants in this study were three patients diagnosed as probable Alzheimer's disease in the initial-to-moderate phase; the three were taking anticholinesterases. They were submitted to a neuropsychological evaluation (NE) before the NRP and then revaluated after 12 and 24 months of treatment. The aim of our intervention was to do practical work with implicit and explicit residual memory by training them in everyday life activities, and using compensatory strategies and their intact cognitive abilities. RESULTS: Analysis of quantitative NE data (descriptive measures) after the first year of NRP showed cognitive improvement, functional stabilization and fewer behavioral problems. However, this improvement did not continue in the second year, and the disease maintained its characteristic progression.
Although the main initial deficit is considered to be in the memory domain, an
early impairment of executive functions is also found in AD where these deficits
are correlated to functional impairment. Ecological tests are more indicated to
evaluate executive impairment, and are better able to assist in treating AD
patients than more commonly used tests.ObjectivesThe aim of this preliminary study is to verify the performance in executive
functions using the Behavioural Assessment of the Dysexecutive Syndrome
(BADS) in elder controls and mild AD patients, and to analyze its
applicability in our environment.MethodsThe BADS was performed by 17 healthy elders and 17 early AD patients matched
for age, schooling and gender.ResultsThere were significant differences among controls and AD patients on MMSE
scores, and in measures of executive functions, memory, and motor speed.
Some sub items of BADS (rule shift cards, modified six elements, total
score, standard, standard by age and overall classification by age) were
also different between groups. Differences were also significant on the
Dysexecutive Questionnaire (DEX) of BADS self-ratings and other-ratings.ConclusionBADS was efficacious in detecting executive deficits in this sample, as
confirmed by other executive functions tests applied.
Objective: Ecological tests are useful in assessing executive function deficits and may be of value in appraising response to treatment in Alzheimer's disease patients. Our aims were to examine executive function using the Behavioral Assessment of the Dysexecutive Syndrome for a Brazilian sample of older-adult controls and probable early Alzheimer's disease patients, and verify the applicability of this test battery. Method: Forty-one older-adult controls were matched with mild Alzheimer's disease patients by age, education, and gender. Results: There significant inter-group differences in overall profile and almost all subtests except temporal judgment, time spent on planning the first and second Zoo Map visit, number of errors when copying drawings, naming pictures and Six Modified Elements arithmetic, and dysexecutive questionnaire self-rating. The Behavioral Assessment of the Dysexecutive Syndrome item that best discriminated controls from patients was the Modified Six Elements -adapted (general index), with a sensitivity of 80% and specificity of 90%, (AUC = 0.91, p < 0.001). Conclusion: Behavioral Assessment of the Dysexecutive Syndrome was effective in detecting executive function deficits in mild Alzheimer's disease patients, particularly the task switching, time monitoring, and rule-shift subtests.
Descriptors
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