Impact of a cognitive rehabilitation intervention on neuropsychiatric symptoms in mild to moderate Alzheimer's disease

Abstract

The main goal of this study was to evaluate the impact of a cognitive rehabilitation programme on 12 behavioural and psychological symptoms of dementia (BPSD) in patients with mild to moderate Alzheimer's disease (AD). This six-month single-blind block-randomised cross-over controlled study was conducted with 15 mild to moderate AD participants and their caregivers. All participants received a four-week home-based cognitive rehabilitation programme to learn/re-learn an instrumental activity of daily living. They were assessed up until three months following the end of the intervention. The Neuropsychiatric Inventory (NPI-12) was employed to evaluate patients' BPSD at seven assessment points during the course of the study. A general linear mixed model analysis performed on the NPI data revealed that aberrant motor behaviours (AMB) increased significantly more in the treatment condition than in the control condition. In addition, both groups registered a significant reduction of delusional symptoms during the second half of the study. Employing a multi-symptom approach to assess participants' BPSD, this cross-over randomised controlled study showed that an individualised cognitive rehabilitation intervention was generally well-tolerated by mild to moderate AD patients. Future cognitive rehabilitation studies conducted with this population should pay attention to AMB symptom changes.

Predictors of non‐pharmacological intervention effect on cognitive function and behavioral and psychological symptoms of older people with dementia

“…The result showed that screening for hearing impairment and treatment of modifiable cause; for example, use of hearing aid, might enhance the effect of the intervention. Interestingly, previous work has shown that non‐pharmacological intervention can also worsen BPSD, especially behavior symptoms, which might be attributed to increasingly perceived environmental stress, and hearing impairment can be one of the possible explanations . In addition, communication impairment did not moderate the effect of intervention in the final analysis.…”

“…Interestingly, previous work has shown that non-pharmacological intervention can also worsen BPSD, especially behavior symptoms, which might be attributed to increasingly perceived environmental stress, and hearing impairment can be one of the possible explanations. 22,33 In addition, communication impairment did not moderate the effect of intervention in the final analysis. Though the result was possibly related to the type of intervention, it implied that participants with communication impairment should not be precluded from the intervention Despite all the efforts that went into the present study, there were several limitations.…”

Incident Psychosis in Subjects With Mild Cognitive Impairment or Alzheimer’s Disease

“…In addition, music therapy, physical activities, art-cognitive activities, and orientation training had favorable outcomes on delusions and hallucinations 39;40 . Home-based cognitive rehabilitation programs for patients with mild to moderate AD have also been shown to significantly reduce delusions 41 . Thus, non-pharmacologic approaches, while not established as preventative, could be considered to prevent or delay psychosis onset in AD 42 .…”

Cognitive impairment and quality of life in patients with myotonic dystrophy type 1

“…Cognitive interventions may also contribute to improvements in the QoL of patients with DM1 because neuropsychological rehabilitation and cognitive remediation have been effective in decreasing impairments associated with other neurological conditions. [50][51][52] In addition, apathy may mediate the influence of cognitive function on QoL, which suggests that the reduction of apathy could lead to better cognitive performance or vice versa. 53 Depression and fatigue are the core predictors of psychological and physical QoL in patients with muscular diseases.…”