Background The existing pharmacological treatments for Alzheimer disease (AD) can only slow the progression of symptoms or delay admission to long-term care facilities. The beneficial effects of non-drug treatments are poorly studied. Objective To describe the effects of an Integrated Psychostimulation Program (IPP) in patients with mild-moderate AD treated with acetylcholinesterase inhibitors; and to identify factors related to greater benefit of the IPP. Methods 206 patients (mean age= 75.9 years; MMSE= 19.6) were evaluated before starting the IPP and 3, 6, 9 and 12 months later. Measures included: Mini-Mental State Examination (MMSE), Cognitive Subscale of Alzheimer’s Disease Assessment Scale (ADAS-Cog), Rapid Disability Rating Scale (RDRS-2) and Neuropsychiatric Inventory Questionnaire (NPI-Q). Results Patients remained cognitively stable (MMSE/ADAS-Cog) for more than 6 months and significantly worsened at 9-month and 12-month follow-ups, without clinically significant functional changes (RDRS-2) or psychiatric symptoms (NPI-Q). The mean annual change on MMSE and ADAS-Cog were 2.06 and 3.56 points, respectively, lower than the annual decline demonstrated previously in similar patients (2.4 and 4.5, respectively). 42.7% of patients maintained or improved global cognitive scores between baseline and 12-month follow-up. The patients who maintained cognitive functions were older than those who did not (77.5 vs. 74.7 years). Conclusions The IPP may be an effective treatment to maintain cognition, functionality and psychiatric symptoms in AD patients pharmacologically treated, and older age seems to increase beneficial effects of IPP.

Alzheimer Society in over 24 communities and delivered in municipal recreation centres, older adult centres or similar multi-service facilities. MiM is in pilot phase until March 2016. This presentation will include conclusive program evidence around participant and staff experience and overview of the design and feasibility of the program. Methods: The objective of MiM is to create safe and supportive environments for people living with dementia to encourage healthy active lifestyles post diagnosis and provide opportunities for service providers to enhance their program delivery and development skills. MiM is evaluated using standardized templates for physical assessments, participant self reports on mood, impact of program on daily life activities and general satisfaction reviews by both participants and service delivery personnel. Alzheimer Society staff and volunteers administer the evaluations and track outcomes. Evaluations indicate 96% of participants enjoy the program with 85% of them returning for additional MiM sessions. 17% of participants leave the program during the 8 weeks, usually due to progression of dementia or other co-morbidities. 90% of staff and volunteers indicate an increase in their knowledge related to dementia and working with older adults. 53% of participants report they have developed new relationships through MiM. Conclusion: The Success of this program is reliant on strong community partnerships to run and promote the program, standardized training and curriculum, volunteer support, reliable transportation options for participants and flexibility in activities to accommodate various abilities. MiM is creating inclusive and supportive environments helping to normalize the experience for participants and expose them to recreation opportunities.

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