Effects of a Goal-Oriented Rehabilitation Program in Mild Cognitive Impairment: A Pilot Study

Londos, Elisabet; Boschian, Kerstin; Lindén, Anita; Persson, Cecilia; Minthon, Lennart; Lexell, Jan

doi:10.1177/1533317507312622

Cited by 64 publications

(64 citation statements)

References 24 publications

(27 reference statements)

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“…Given the relative lack of tests and growing importance of such measures, it is clear that the development of ecologically valid tests would benefit rehabilitation research as well as the general field of Neuropsychology. 5,7,15,16,17,18,24,25,27,30,31,33 12 Narrative memory (other) 3,23,28,30 18,23,26,33, 15,21,22,30,31,33 6 Rivermead Behavioural Memory Test (RBMT) 7,8,16,17,26,27,31,33,34 3,7,23,30,31,36 1,3,4,5,15,28,29,32 1 The ...…”

Section: Methodological Challenge 4: Outcome Measuresmentioning

confidence: 99%

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Hampstead

Gillis

Stringer

2013

J Int Neuropsychol Soc

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Several recent reviews have suggested that cognitive rehabilitation may hold promise in the treatment of memory deficits experienced by patients with mild cognitive impairment. In contrast to the previous reviews that mainly focused on outcome, the current review examines key methodological challenges that are critical for designing and interpreting research studies and translating results into clinical practice. Using methodological details from 36 studies, we first examine diagnostic variability and how the use of cutoffs may bias samples toward more severely impaired patients. Second, the strengths and limitations of several common rehabilitative techniques are discussed. Half of the reviewed studies used a multi-technique approach that precludes the causal attribution between any specific technique and subsequent improvement. Third, there is a clear need to examine the dose-response relationship since this information was strikingly absent from most studies. Fourth, outcome measures varied widely and frequently depended on neuropsychological tests with little theoretical justification or ecological relevance. Fifth, we discuss how the variability in each of these other four areas complicates efforts to examine training generalization. Overall, future studies should place greater emphasis on ecologically relevant treatment approaches and outcome measures and we propose a hierarchical model that may aid in this pursuit. (JINS, 2014, 20, 135-151)

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Section: Methodological Challenge 4: Outcome Measuresmentioning

confidence: 99%

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Hampstead

Gillis

Stringer

2013

J Int Neuropsychol Soc

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“…The results of our study might be limited by the relatively small sample size (n = 25) although other cognitive intervention studies recruited even fewer participants (n < 20, e.g., [12,14]). When using a bootstrapping technique [46] to evaluate the stability of our key finding, the same variables became significant in 72% (volume of the left entorhinal cortex) and 85% (motivation) of all 1000 subsamples (Supplementary Table 5).…”

Section: Limitationmentioning

confidence: 93%

“…The combined training study by Londos and colleagues [12] for example, found 47% improved, 40% remained unchanged, while 13% worsened in processing speed. In another study in individuals with subjective, but not objective, memory impairment (SMI, a population at increased risk of developing dementia; n = 19), 21% worsened after cognitive training [14].…”

Section: Introductionmentioning

confidence: 99%

“…Two studies found strategy training to stabilize verbal delayed recall over three or six months, respectively, despite a progressing neurodegenerative disorder [10,11]. An additional study (n = 15) reported improved processing speed in MCI, when combining strategy training with psychoeducation; the effects were maintained after 6-months follow-up [12] and even for up to 28 months for the MMSE [13]. Thus, strategy training seems to be promising in prodromal stages of AD, providing the possibility to offer an early intervention.…”

Section: Introductionmentioning

confidence: 99%

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[P4–026]: Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment

Peter

Klöppel

2017

Alzheimer's & Dementia

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Abstract. In mild cognitive impairment (MCI), small benefits from cognitive training were observed for memory functions but there appears to be great variability in the response to treatment. Our study aimed to improve the characterization and selection of those participants who will benefit from cognitive intervention. We evaluated the predictive value of diseasespecific biological factors for the outcome after cognitive training in MCI (n = 25) and also considered motivation of the participants. We compared the results of the cognitive intervention group with two independent control groups of MCI patients (local memory clinic, n = 20; ADNI cohort, n = 302). The primary outcome measure was episodic memory as measured by verbal delayed recall of a 10-word list. Episodic memory remained stable after treatment and slightly increased 6 months after the intervention. In contrast, in MCI patients who did not receive an intervention, episodic memory significantly decreased during the same time interval. A larger left entorhinal cortex predicted more improvement in episodic memory after treatment and so did higher levels of motivation. Adding disease-specific biological factors significantly improved the prediction of training-related change compared to a model based simply on age and baseline performance. Bootstrapping with resampling (n = 1000) verified the stability of our finding. Cognitive training might be particularly helpful in individuals with a bigger left entorhinal cortex as individuals who did not benefit from intervention showed 17% less volume in this area. When extended to alternative treatment options, stratification based on disease-specific biological factors is a useful step towards individualized medicine.

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“…Goal-oriented rehabilitation with an educational component, memory strategies, mind-mapping and goal planning, led to better occupational performance and quality of life (Londos et al 2008). …”

Section: Introductionmentioning

confidence: 99%

Conceptualisation of self-management intervention for people with early stage dementia

et al. 2012

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Dementia is a major challenge for health and social care services. People living with dementia in the earlier stages experience a ''care-gap''. Although they may address this gap in care, self-management interventions have not been provided to people with dementia. It is unclear how to conceptualise self-management for this group and few published papers address intervention design. Initial focusing work used a logic mapping approach, interviews with key stakeholders, including people with dementia and their family members. An initial set of self-management targets were identified for potential intervention. Self-management for people living with dementia was conceptualised as covering five targets: (1) relationship with family, (2) maintaining an active lifestyle, (3) psychological wellbeing, (4) techniques to cope with memory changes, and (5) information about dementia. These targets were used to focus literature reviewing to explore an evidence base for the conceptualisation. We discuss the utility of the Corbin and Strauss (Unending work and care: managing chronic illness at home. JosseyBass, Oxford, 1988) model of self-management, specifically that self-management for people living with dementia should be conceptualised as emphasising the importance of ''everyday life work'' (targets 1 and 2) and ''biographical work'' (target 3), with inclusion of but less emphasis on specific ''illness work'' (targets 4, 5). We argue that selfmanagement is possible for people with dementia, with a strengths focus and emphasis on quality of life, which can be achieved despite cognitive impairments. Further development and testing of such interventions is required to provide much needed support for people in early stages of dementia.

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Effects of a Goal-Oriented Rehabilitation Program in Mild Cognitive Impairment: A Pilot Study

Abstract: As this goal-oriented rehabilitation program in MCI resulted in some improvements in cognition, occupational performance, and QoL, further randomized controlled studies are warranted.

Cited by 64 publications

References 24 publications

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

Cognitive Rehabilitation of Memory for Mild Cognitive Impairment: A Methodological Review and Model for Future Research

[P4–026]: Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment

Conceptualisation of self-management intervention for people with early stage dementia

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