Effects of a multidisciplinar cognitive rehabilitation program for patients with mild Alzheimer's disease

Abstract

OBJECTIVE:To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatric symptoms in patients with mild Alzheimer's disease.METHOD:The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention.INTERVENTION:Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings.MEASUREMENTS:The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments.RESULTS:Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life.CONCLUSION:This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and clinically relevant benefits in dementia treatment.

A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

“…Stability of scores or an attenuation of decline was reported in six group studies (Arkin, 2007;Graessel et al, 2011;Ibarria et al, 2016;La Rue et al, 2015;Maci et al, 2012;Viola et al, 2011). Two group studies, Serda`i Ferrer and del Table 6.…”

“…For instance, the CDR global score has been recommended as a staging or impression of change outcome measure in future studies (Webster et al, 2017). The Short Cognitive Test (SKT) has also been known to be 'more sensitive to subtle changes' than the MMSE as it is a 'more comprehensive cognitive assessment battery and takes account processing speed and response accuracy' (Viola et al, 2011). Study design -Pharmacology and the Naturalistic.…”

The intervention of the physiotherapist in the patient with dementia in palliative care

“…With the application of this program, the patient's neuropsychiatric symptoms were reduced, the caregiver's degree of concern decreased, and the depressive symptoms of both were reduced. It was found that cognitive function remained stable and that the quality of life improved (Viola, et al, 2011). McLaren, LaMantia & Callahan have developed a systematic review of the literature in which the aim was to determine whether non-pharmacological measures such as exercise, occupational therapy and other multidisciplinary interventions contribute to delayed functional decline in community-dwelling dementia patients.…”

“…This happens because of the current aging of the population and increase in the average life expectancy (Burton, et al, 2015;Kumar, et al, 2014). Alzheimer's disease and vascular dementia are the most common types of dementia (Burton, et al, 2015;Viola, et al, 2011;McLaren, LaMantia, & Callahan, 2013). The sedentary lifestyle also contributed to the decline of cognitive function, irritation, confusion, depression and fatigue (Winchestera, et al, 2013).…”

Tratamentos não farmacológicos que melhoram a qualidade de vida de idosos com doença de Alzheimer: uma revisão sistemática

“…Os dados dos estudos mostram que: 1) todos os trabalhos foram realizados com idosos em estágio leve da DA; 2) Apenas um estudo foi realizado em instituição de longa permanência 12 [12][13][14] . A arteterapia apareceu em apenas um estudo como intervenção principal a ser investigada 11 , porém ela também foi utilizada no estudo de Viola et al 14 como parte da reabilitação multidisciplinar empregada.…”