A Cluster Randomized Controlled Trial of Nonpharmacological Interventions for Old-Old Subjects with a Clinical Dementia Rating of 0.5: The Kurihara Project

Abstract

Background: Evidence as to the benefits of nonpharmacological interventions for the boundary state between normal aging and dementia [mild cognitive impairment or a Clinical Dementia Rating (CDR) of 0.5] remains weak due to a lack of positive controls. Aims: To directly compare the effects of cognitive interventions (CI), physical activities (PA) and a group reminiscence approach (GRA), we conducted a pilot study on the basis of a cluster randomized controlled trial design. Method: A total of 127 participants aged >74 years with a CDR of 0.5 were cluster randomized into three groups for CI, PA and GRA. The intervention lasted 12 weeks and consisted of weekly group sessions and home assignments. Mini-Mental State Examination (MMSE), Trail Making Test part A (TMT-A), word fluency (WF), 6-meter walk time and Quality of Life (QOL) Face Scale scores were evaluated as primary outcomes. Results: Methodology-related benefits of CI and PA were found for MMSE scores and walk time, respectively. TMT-A, WF and QOL Face Scale scores improved irrespective of the methodologies used. Conclusions: Our findings suggest that CI and PA may be beneficial to cognitive and physical abilities, respectively. Executive functions and QOL may improve irrespective of the intervention methodologies used.

Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

“…Of these, six were computerized interventions, 14 were therapist-based interventions, and 10 multimodal studies. In the multimodal studies, cognitive outcomes compared to a control group could be extracted from one additional computerized (Fiatarone Singh et al 2014) and two additional therapist-based interventions (Lam et al 2015; Nakatsuka et al 2015). Thus, aspects of these studies appear in both analyses: the isolated cognitive intervention outcomes in the respective computerized or therapist-based intervention sections, and the cognitive intervention outcomes when combined with other nonpharmacological interventions in the multi-modal section.…”

“…Nakatsuka et al (2015) had both group and in-home individual sessions. In terms of the therapy content, two studies focused exclusively on one specific type of learning strategy: repetition lag training (Finn and McDonald 2015) or errorless learning (Jean et al 2010b).…”

Measurement tools of resource use and quality of life in clinical trials for dementia or cognitive impairment interventions: A systematically conducted narrative review

“…QOL Face Scale is a 9‐choice picture format with a score range of 1–9 (worst = 1, best = 9, from frowning to smiling faces) assessing the degree of general happiness in current daily life. It was used to ask the caregivers to answer these questions on behalf of the patients with dementia …”

“…It was used to ask the caregivers to answer these questions on behalf of the patients with dementia. 45 Quality of Life Assessment-Patient (QLA-P)…”

Addressing Adventitious Behaviors Associated with Dementia

“…Informal studies such as surveys can demonstrate largely general demographic information with little benefit to the individual patient [3]. Others were so specific to be limited by geographical, cultural, and ethnocentric considerations [4]. While systematic reviews and meta-analyses are important facets in academia and progressive research, they often fail to result in new standards of care or act as seminal sources of research.…”