We examined whether errorless learning (EL) and learning by modeling (LM) were more advantageous than trial and error learning (TEL) in the acquisition of instrumental activities of daily living (IADL) in Alzheimer's dementia (AD) patients (n = 14). Using a counterbalanced within-subject design, participants performed 3 learning conditions. EL consisted of straightforward prompts before any action, LM focused on the modeling of each step of the tasks and standard TEL without cues was used as a control condition. The participants had to (re)learn 3 IADL. Repeated-measure analyses during learning and follow-up assessments were performed 1 and 3 weeks after learning. The LM and the EL procedures resulted in significantly better learning compared to TEL, with effect sizes (partial eta squared) of 0.42 and 0.35, respectively. This is the first controlled study to show that (re)learning of IADL is possible in patients with AD using an error-reduction approach.
Overall, VKA control remains insufficient in very old patients. Poorer VKA control was associated with taking VKA for a prosthetic heart valve, a recent VKA prescription, the use of other VKAs than warfarin, a history of overcoagulation and major bleeding, antibiotic use, and falls.
Behavioural and psychological symptoms of dementia (BPSD) such as agitation, aggressiveness, oppositional behaviour and psychotic symptoms are often reported by caregivers and staff members in institutions for the elderly. Taking into account the limited efficacy and the importance of side effects observed with psychotropic agents, the majority of existing guideline underlines the importance of non-pharmacological strategies. The aim of this article is to describe the major methodological problems in non-pharmacological treatments studies and to present the design of the TNM study, a nursing home randomized controlled trial conducted in 16 French nursing homes.
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