Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia

Abstract

Background: Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective: This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer's disease (AD) and cognitive impairment without dementia (CIND). Methods: Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54) or control (n = 16) groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13) or with CIND (n = 14) who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results: As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021) and quality of life (p = 0.003), along with a reduction in depressive symptoms (p < 0.001). As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005) and depressive symptoms (p = 0.011). No such benefits were found among patients with moderate AD. Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention.

Neuroendocrine and neurotrophic signaling in Huntington’s disease: Implications for pathogenic mechanisms and treatment strategies

“…Recent data from our research programme has shown, in particular, that multidisciplinary therapy increases grey matter volume in the caudate tail and dorsolateral PFC in patients with manifest HD (147). This therapy has also been reported to improve cognitive function, quality of life and depressive symptoms in patients with mild AD and cognitive impairment without dementia (148) and in PD, multidisciplinary therapy has been reported to improve motor performance, dyskinesias, balance and gait and slow disease progression (149)(150)(151). The molecular mechanisms driving these neural and clinical changes are yet to be investigated.…”

Efeitos de programas de reabilitação multidisciplinar no tratamento de pacientes com doença de Alzheimer: uma revisão sistemática

“…Assim, um total de cinco artigos foram incluídos e descritos no presente estudo [18][19][20][21][22] . As razões para exclusão dos demais estudos foram: não eram experimentais, não realizaram uma intervenção multidisciplinar ou não eram pacientes com Os estudos foram sumarizados na Tabela 1, sendo três ensaios controlados 18,19,22 , um ensaio clínico aleatorizado 20 e um quase aleatorizado 21 , com qualidade metodológica média de 5,4 pontos na escala PEDro (variação de 4 a 7) (Tabela 2). Todos os estudos foram realizados com amostra de conveniência e incluíram 576 participantes, com idade média de 77,7 anos, dos quais 236 eram homens.…”

“…Dois estudos incluíram pacientes com DA leve 21,22 , um estudo incluiu pacientes com DA avançada 20 e dois deles não especificaram a fase da doença em que os participantes se encontravam 18,19 . Apesar de os tratamentos terem como foco principal a multidisciplinaridade, três estudos não citaram os profissionais envolvidos, embora relatassem a aplicação de um protocolo multidisciplinar 18,21,22 . Dos demais estudos, as modalidades profissionais incluídas nas equipes multiprofissionais foram: enfermeiro, médico (neurologista), psicólogo e fisioterapeuta.…”

“…A depressão também foi avaliada em todos os cinco artigos, obtendo melhora em três deles no grupo experimental para os pacientes 18,20,21 , enquanto um encontrou melhora dos sintomas depressivos nos cuidadores, quando comparados ao grupo controle 22 . Os resultados apontam que as consultas multidisciplinares e a reunião conjunta foram eficazes na redução dos sintomas depressivos 18, [20][21][22] . Esses resultados são importantes, uma vez que a depressão é um dos sintomas mais frequentes da DA, podendo ser um dos primeiros sintomas da doença, antes mesmo da perda de memória 24 .…”

Translation and transcultural adaptation to Brazilian Portuguese of the Theory of Mind Task Battery for assessment of social cognition in the elderly

“…Therefore, the ToM TB must be considered as an alternative for these populations, since the tool proposes to assess the theory of mind at different levels of linguistic and cognitive capacity. In addition, researches with cognitive rehabilitation programs have pointed to improvement in several cognitive domains 8 without assessment of social cognition, so the ToM TB could be used in intervention studies to evaluate this important domain.…”