Long-term cognitive treatment of Alzheimer's disease: A single case study

Abstract

The effects of long-term treatment in a demented patient were evaluated in this study. One individual diagnosed with Alzheimer's dementia (AD) was treated with neuropsychological rehabilitation techniques as well as drugs for a period of 2 years and 10 months. An A-B-A-B design was performed for the cognitive treatment. Neuropsychological treatment consisted of a combination of direct re-training and training in activities of daily living. Cognitive performance was monitored with the Mattis Dementia Rating Scale. Results showed improvement and a slower decline during the treatment phases (A) as compared to the no-treatment phases (B). The Conceptualisation and Attention subscales benefited most followed by the Memory subscale. Long-term treatment was shown to be effective in AD. Although cognitive drugs may have been beneficial neuropsychological rehabilitation played an important role in the success of this treatment, appearing as a necessary condition.

Cognitive Training for Early-Stage Alzheimer's Disease and Dementia

“…Limited research is available regarding the effect of neuropsychological rehabilitation in individuals with earlystage AD. In a case study by Fernández, Manoiloff, and Monti (2006), one man with AD was followed over 34 months and was treated with two different cholinesterase inhibitors at different times, which alternated with neuropsychological rehabilitation. Although the participant did experience cognitive decline over time, the decline occurred at a much slower rate than would be projected (Fernández et al, 2006, evidence grade: D1).…”

Observations on strategies used by people with dementia to manage being assessed using validated measures: A pilot qualitative video analysis

“…Ward et al's 10 review on evaluating cognitive stimulation highlighted that insufficient information is given about how the assessment of people with dementia is conducted. They also noted that little is reported on how these tests are experienced and what impact there is on the subjective interpretation of the tests by people with dementia, something that has been criticized in cognitive stimulation effect research 11–13 . However, it is important to identify measures that are acceptable for both the research community and for those diagnosed with dementia, including reducing any impact in terms of distress, confusion, anxiety or burden in participating 8 .…”

“…They also noted that little is reported on how these tests are experienced and what impact there is on the subjective interpretation of the tests by people with dementia, something that has been criticized in cognitive stimulation effect research. [11][12][13] However, it is important to identify measures that are acceptable for both the research community and for those diagnosed with dementia, including reducing any impact in terms of distress, confusion, anxiety or burden in participating. 8 Heggestad et al 14 argue that the assessment process can be humiliating, and people with dementia may experience a loss of dignity in taking a test.…”

Preventive Therapy of Mental Disorders

“…Notably, that behavioural therapy, e.g. training that sharpens the executive functioning in case of schizophrenia [6]; long-term memories in case of patients with Alzheimer' disorder (AD) [7], early intensive behavioural interventions in case of people with autism [8] and social behavioural therapy in case of patients with major depression [9] improves symptoms even more effectively than drug medication. This fact provides the evidence that brain is plastic and approaches based on neuronal plasticity and neurotechnologies may appear as a main strategy for preventive medicine in the near future.…”