Effects of a Newly Developed Cognitive Intervention in Amnestic Mild Cognitive Impairment and mild Alzheimer's disease: A Pilot Study

Buschert, Verena; Friese, Uwe; Teipel, Stefan J.; Schneider, P.; Merensky, Wibke; Rujescu, Dan; Möller, Hans‐Jürgen; Hampel, Harald; Büerger, Katharina

doi:10.3233/jad-2011-100999

Cited by 135 publications

(141 citation statements)

References 66 publications

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“…Given the relative lack of tests and growing importance of such measures, it is clear that the development of ecologically valid tests would benefit rehabilitation research as well as the general field of Neuropsychology. 5,7,15,16,17,18,24,25,27,30,31,33 12 Narrative memory (other) 3,23,28,30 18,23,26,33, 15,21,22,30,31,33 6 Rivermead Behavioural Memory Test (RBMT) 7,8,16,17,26,27,31,33,34 3,7,23,30,31,36 1,3,4,5,15,28,29,32 1 The ...…”

Section: Methodological Challenge 4: Outcome Measuresmentioning

confidence: 99%

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Hampstead

Gillis

Stringer

2013

J Int Neuropsychol Soc

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Several recent reviews have suggested that cognitive rehabilitation may hold promise in the treatment of memory deficits experienced by patients with mild cognitive impairment. In contrast to the previous reviews that mainly focused on outcome, the current review examines key methodological challenges that are critical for designing and interpreting research studies and translating results into clinical practice. Using methodological details from 36 studies, we first examine diagnostic variability and how the use of cutoffs may bias samples toward more severely impaired patients. Second, the strengths and limitations of several common rehabilitative techniques are discussed. Half of the reviewed studies used a multi-technique approach that precludes the causal attribution between any specific technique and subsequent improvement. Third, there is a clear need to examine the dose-response relationship since this information was strikingly absent from most studies. Fourth, outcome measures varied widely and frequently depended on neuropsychological tests with little theoretical justification or ecological relevance. Fifth, we discuss how the variability in each of these other four areas complicates efforts to examine training generalization. Overall, future studies should place greater emphasis on ecologically relevant treatment approaches and outcome measures and we propose a hierarchical model that may aid in this pursuit. (JINS, 2014, 20, 135-151)

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Section: Methodological Challenge 4: Outcome Measuresmentioning

confidence: 99%

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Hampstead

Gillis

Stringer

2013

J Int Neuropsychol Soc

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“…49,51,53 All of the studies reported on attrition to the programme, although the intention-to-treat analysis plan was described in only two. 6,51 Given the nature of the condition and the age of the participants, attrition in several studies was remarkably small, with zero attrition recorded in six studies [48][49][50]52,59,60 out of 180 participants. The largest attrition rate was reported in the study by Wallis et al, 63 in which there was 39% attrition in the group of participants with dementia.…”

Section: Figurementioning

confidence: 99%

“…47 Two reviewers independently assessed eligibility. Of the 94 references, nine studies met the inclusion criteria [48][49][50][51][52][53][54][55] and were included in the analysis. Three recent studies were left awaiting classification.…”

Section: Studies Included In the Reviewmentioning

confidence: 99%

“…Data were identified, included and pooled from the 15 included RCTs, 6,[48][49][50][51][52][53][54][55][59][60][61][62][63][64] with a total of 718 participants (407 in experimental groups and 311 in control groups). Analyses were adjusted to the random-effects model, owing to the heterogeneity of trials, and SMDs, because trials used different measures to assess the same outcomes.…”

Section: Meta-analysismentioning

confidence: 99%

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Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Orrell

Hoe

Charlesworth

et al. 2017

Programme Grants Appl Res

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BackgroundDementia is a national priority and this research addresses the Prime Minister’s commitment to dementia research as demonstrated by his 2020 challenge and the new UK Dementia Research Institute. In the UK > 800,000 older people have dementia. It has a major impact on the lives of people with dementia themselves, on the lives of their family carers and on services, and costs the nation £26B per year. Pharmacological cures for dementias such as Alzheimer’s disease are not expected before 2025. If no cure can be found, the ageing demographic will result in 2 million people living with dementia by 2050. People with dementia lose much more than just their memory and their daily living skills; they can also lose their independence, their dignity and status, their confidence and morale, and their roles both within the family and beyond. They can be seen as a burden by society, by their families and even by themselves, and may feel unable to contribute to society. This programme of research aims to find useful interventions to improve the quality of life of people with dementia and their carers, and to better understand how people with dementia can be supported at home and avoid being admitted to hospital.Objectives(1) To develop and evaluate the maintenance cognitive stimulation therapy (MCST) for people with dementia; (2) to develop the Carer Supporter Programme (CSP), and to evaluate the CSP and Remembering Yesterday, Caring Today (RYCT) for people with dementia both separately and together in comparison with usual care; and (3) to develop a home treatment package (HTP) for dementia, to field test the HTP in practice and to conduct an exploratory trial.Methods(1) The MCST programme was developed for people with dementia based on evidence and qualitative work. A randomised controlled trial (RCT) [with a pilot study of MCST plus acetylcholinesterase inhibitors (AChEIs)] compared MCST with cognitive stimulation therapy (CST) only. The MCST implementation study conducted a trial of outreach compared with usual care, and assessed implementation in practice. (2) The CSP was developed based on existing evidence and the engagement of carers of people with dementia. The RCT (with internal pilot) compared the CSP and reminiscence (RYCT), both separately and in combination, with usual care. (3) A HTP for dementia, including the most promising interventions and components, was developed by systematically reviewing the literature and qualitative studies including consensus approaches. The HTP for dementia was evaluated in practice by conducting in-depth field testing.Results(1) Continuing MCST improved quality of life and improved cognition for those taking AChEIs. It was also cost-effective. The CST implementation studies indicated that many staff will run CST groups following a 1-day training course, but that outreach support helps staff go on to run maintenance groups and may also improve staff sense of competence in dementia care. The study of CST in practice found no change in cognition or quality of life at 8-month follow-up. (2) The CSP/RYCT study found no benefits for family carers but improved quality of life for people with dementia. RYCT appeared beneficial for the quality of life of people with dementia but at an excessively high cost. (3) Case management for people with dementia reduces admissions to long-term care and reduces behavioural problems. In terms of managing crises, staff suggested more costly interventions, carers liked education and support, and people with dementia wanted family support, home adaptations and technology. The easy-to-use home treatment manual was feasible in practice to help staff working in crisis teams to prevent hospital admissions for people with dementia.LimitationsGiven constraints on time and funding, we were unable to compete the exploratory trial of the HTP package or to conduct an economic evaluation.Future researchTo improve the care of people with dementia experiencing crises, a large-scale clinical trial of the home treatment manual is needed.ConclusionThere is an urgent need for effective psychosocial interventions for dementia. MCST improved quality of life and was cost-effective, with benefits to cognition for those on AChEIs. MCST was feasible in practice. Both CSP and RYCT improved the quality of life of people with dementia, but the overall costs may be too high. The HTP was useful in practice but requires evaluation in a full trial. Dementia care research may improve the lives of millions of people across the world.Trial registrationsCurrent Controlled Trials ISRCTN26286067 (MCST), ISRCTN28793457 (MCST implementation) and ISRCTN37956201 (CSP/RYCT).FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 5. See the NIHR Journals Library website for further project information.

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“…Furthermore, psychoeducational elements e.g. with topics related to healthy cognitive aging including risk and protective factors, mechanisms of cognitive functions, or cognitive strategies are part of some cognitive group trainings which were developed for elderly people with or without cognitive dysfunctions [15] [16] [17] [18], but are usually not implemented in digital trainings. However, standardized CCT programs tailored for elderly people could be especially useful, as they would constitute a form of "guided" training [11] for this group.…”

Section: Introductionmentioning

confidence: 99%

Computerized Cognitive Training in Healthy Older Adults: Baseline Cognitive Level and Subjective Cognitive Concerns Predict Training Outcome

Kalbe¹,

Bintener²,

Ophey³

et al. 2018

Health

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Computerized cognitive training (CCT) can improve cognition in older adults. However, specific programs for this target group have rarely been developed, and predictors of training success are largely unclear. In a randomized controlled pilot trial, we examined effects of a six-week CCT, tailored to the cognitive profile of healthy older adults (EG, n = 21) as compared to a nonspecific CCT (CG, n = 18) matched in frequency and intensity. No interaction effects between Group and Time were found. However, within-group analysis showed significant gains in verbal and non-verbal memory, executive and visuospatial functions and subjective cognitive concerns (SCC) in the EG, while the CG only benefitted in non-verbal memory and set-shifting. Low cognitive performance and lower SCC at baseline were the most consistent predictors of cognitive gains in the EG. Thus, CCTs specifically tailored to older adults seem advantageous compared to non-specific CCT. Further, we conclude that SCC may be related to reduced cognitive plasticity.

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Effects of a Newly Developed Cognitive Intervention in Amnestic Mild Cognitive Impairment and mild Alzheimer's disease: A Pilot Study

Cited by 135 publications

References 66 publications

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Computerized Cognitive Training in Healthy Older Adults: Baseline Cognitive Level and Subjective Cognitive Concerns Predict Training Outcome

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