A Randomized Cross-over Controlled Study on Cognitive Rehabilitation of Instrumental Activities of Daily Living in Alzheimer Disease

Thivierge, Stéphanie; Jean, Léonie; Simard, Martine

doi:10.1016/j.jagp.2013.03.008

Cited by 60 publications

(112 citation statements)

References 29 publications

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“…Second, we employed usual care as a control instead of mock therapy. Third, our sample size was relatively small, but was notably consistent with most previous RCTs on SRT [9, 31, 32, 41]. Fourth, subtypes and causes of MCI were not adjusted for in the analysis.…”

Section: Discussionmentioning

confidence: 77%

“…Previous RCTs indicate that SRT is effective in improving training content-associated tests in various cognitive domains and functions such as personal information recall [31], name–face association [31], instrumental activities of daily living [32], and problematic behaviors such as eating difficulty [33]. However, these studies did not find a generalization of the SRT effects to neuropsychological tests independent of training content in the SRT [31, 32], except in a measure of attention [31].…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies did not find a generalization of the SRT effects to neuropsychological tests independent of training content in the SRT [31, 32], except in a measure of attention [31]. …”

Section: Discussionmentioning

confidence: 99%

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Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial

et al. 2017

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BackgroundSpaced retrieval training (SRT) is a nonpharmacological intervention for mild cognitive impairment (MCI) and dementia that trains the learning and retention of target information by recalling it over increasingly long intervals. We recently developed the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program as a convenient, self-administered tablet-based SRT program. We also demonstrated the utility of USMART for improving memory in individuals with MCI through an open-label uncontrolled trial.MethodsThis study had an open-label, single-blind, randomized, controlled, two-period crossover design. Fifty patients with MCI were randomized into USMART–usual care and usual care–USMART treatment sequences. USMART was completed or usual care was provided biweekly over a 4-week treatment period with a 2-week washout period between treatment periods. Primary outcome measures included the Word List Memory Test, Word List Recall Test (WLRT), and Word List Recognition Test. Outcomes were measured at baseline, week 5, and week 11 by raters who were blinded to intervention type. An intention-to-treat analysis and linear mixed modeling were used.ResultsOf 50 randomized participants, 41 completed the study (18% dropout rate). The USMART group had larger improvements in WLRT score (effect size = 0.49, p = 0.031) than the usual care group. There were no significant differences in other primary or secondary measures between the USMART and usual care groups. Moreover, no USMART-related adverse events were reported.ConclusionsThe 4-week USMART modestly improved information retrieval in older people with MCI, and was well accepted with minimal technical support.Trial registrationClinicalTrials.gov NCT01688128. Registered 12 September 2012.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial

et al. 2017

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“…As an example, exercise in Alzheimer's disease patients has recently been shown to benefit cognitive function and lead to better ADL function . Evidence also suggests cognitive interventions among patients with Alzheimer's disease promote preservation of complex instrumental ADL . Future studies should investigate whether participation in exercise programs (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…43 Evidence also suggests cognitive interventions among patients with Alzheimer's disease promote preservation of complex instrumental ADL. 44 Future studies should investigate whether participation in exercise programs (e.g. cardiac rehabilitation) improves neurocognitive function in HF and subsequently preserves functional independence.…”

Section: Discussionmentioning

confidence: 99%

Cognitive dysfunction mediates the effects of poor physical fitness on decreased functional independence in heart failure

Alosco

Spitznagel

Sweet

et al. 2014

Geriatrics Gerontology Int

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Aim Heart failure (HF) patients require assistance with activities of daily living (ADL). Poor physical fitness has recently been identified as a contributor to the high rates of disability in HF, though the mechanisms for such effects are unclear. Although not previously examined, decreased fitness may adversely impact ADLs in HF through its known association with cognitive impairment, a key correlate of self-care abilities in this population. We sought to test this possibility using a model-based approach. Methods 197 patients with HF completed a physical fitness test and a neuropsychological test battery. A total ADL composite was derived from the Lawton Brody scale. Structural equation modeling tested whether cognitive function mediated the association between physical fitness and total ADLs. Results Fitness was reduced and cognitive dysfunction and impaired ADLs were prevalent. The initially significant association between fitness and total ADLs was attenuated when cognitive function was introduced as a mediator. This model demonstrated good fit (CFI = .91: RMSEA = .077) with a significant indirect pathway between physical fitness and total ADLs through cognitive function: Decreased physical fitness was associated with cognitive dysfunction (β = 0.35), which predicted greater assistance with ADLs (β = 0.22). Conclusions Poor physical fitness may lead to decreased functional independence in HF through its negative effects on cognitive function. Prospective studies are needed to confirm our findings, identify other mechanisms by which poor fitness impacts ADLs, and examine whether exercise interventions can improve cognition and help preserve ADL independence in HF.

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Cognitive rehabilitation for people with mild to moderate dementia

Kudlicka

Martyr

Bahar‐Fuchs

et al. 2019

Cochrane Database of Systematic Reviews

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A Randomized Cross-over Controlled Study on Cognitive Rehabilitation of Instrumental Activities of Daily Living in Alzheimer Disease

Cited by 60 publications

References 29 publications

Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial

Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial

Cognitive dysfunction mediates the effects of poor physical fitness on decreased functional independence in heart failure

Cognitive rehabilitation for people with mild to moderate dementia

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