Group and individual cognitive therapies in Alzheimer's disease: the ETNA3 randomized trial

Amieva, Hélène; Robert, P; Grandoulier, Anne-Sophie; Meillon, Céline; Rotrou, J. de; Andrieu, Sandrine; Berr, Claudine; Desgranges, Béatrice; Dubois, Bruno; Girtanner, C.; Joël, Marie-Ève; Lavallart, Benoît; Nourhashémi, Fati; Pasquier, Florence; Rainfray, Muriel; Touchon, Jacques; Chêne, Geneviève; Dartigues, Jean‐François

doi:10.1017/s1041610215001830

Cited by 107 publications

(141 citation statements)

References 32 publications

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“…22 Previous reviews reported that cognitive stimulation therapy and cognitive training are not effective at reducing cognitive decline, while there was some evidence for individual cognitive rehabilitation from a single trial. 35 Our findings are in line with current theoretical models describing how best to support people with dementia to live at home. 35 Our findings are in line with current theoretical models describing how best to support people with dementia to live at home.…”

Section: Discussionsupporting

confidence: 89%

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Scott

Cooper

Leverton

et al. 2019

Int J Geriat Psychiatry

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Objective Slowing functional decline could enable people living with dementia to live for longer and more independently in their own homes. We aimed to update previous syntheses examining the effectiveness of nonpharmacological interventions in reducing functional decline (activities of daily living, activity‐specific physical functioning, or function‐specific goal attainment) in people living in their own homes with dementia. Methods We systematically searched electronic databases from January 2012 to May 2018; two researchers independently rated risk of bias of randomised controlled trials (RCTs) fitting predetermined inclusion criteria using a checklist; we narratively synthesised findings, prioritising studies judged to have a lower risk of bias. Results Twenty‐nine papers (describing 26 RCTs) met eligibility criteria, of which we judged 13 RCTs to have a lower risk of bias. Study interventions were evaluated in four groups: physical exercise, occupational, multicomponent, and cognition‐oriented interventions. Four out of 13 RCTs reported functional ability as a primary outcome. In studies judged to have a lower risk of bias, in‐home tailored exercise, individualised cognitive rehabilitation, and in‐home activities‐focussed occupational therapy significantly reduced functional decline relative to control groups in individual studies. There was consistent evidence from studies at low risk of bias that group‐based exercise and reminiscence therapies were ineffective at reducing functional decline. Conclusion We found no replicated evidence of intervention effectiveness in decreasing functional decline. Interventions associated with slower functional decline in individual trials have been individually delivered and tailored to the needs of the person with dementia. This is consistent with previous findings. Future intervention trials should prioritise these approaches.

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Section: Discussionsupporting

confidence: 89%

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Scott

Cooper

Leverton

et al. 2019

Int J Geriat Psychiatry

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“…In these two studies, patients of the experimental group increased their cognition relatively more than the control group after intervention, both for the ADAS-Cog and the MMSE. Other studies showed no significant differences between the conditions with regard to cognition [34,35,45,46,49,51,55,57,58]. Studies that used other assessment tools to measure cognitive impairment showed also positive effects.…”

Section: Skills Training Trialsmentioning

confidence: 94%

“…Most studies included elderly with mild cognitive impairments [35, 36, 41-43, 47, 49-51, 53, 55, 56], some studies included elderly at risk for dementia [38,52,58], some other studies patients with mild to moderate dementia [37,46,57], moderate to severe dementia [34,48], diagnosed with Alzheimer disease [39,40,44,45,48,51,54].…”

Section: Skills Training Trialsmentioning

confidence: 99%

“…Therapy was heterogeneous in number, duration, and length of the sessions. For example, Amieva et al [34] conducted treatment for 2 years, starting with weekly sessions (90 min per session), while Gagnon and Belleville [41] only conducted treatment for 2 weeks, 3 times a week (60 min per session). Control conditions varied also between studies, from active music therapy and neuro-education [42] to pharmacotherapy [45], waitlist [39], or pencil-paper exercises for self-study.…”

Section: Skills Training Trialsmentioning

confidence: 99%

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Cognitive Therapy for Dementia Patients: A Systematic Review

Carrión

Folkvord

Anastasiadou

et al. 2018

Dement Geriatr Cogn Disord

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Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed. Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia. Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment. Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found. Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed.

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“…Cognitive rehabilitation is usually carried out in the setting where the person lives or undertakes activities, to ensure direct relevance, and carers and families, when available and willing, are fully involved and appropriately supported. There is a small but growing evidence base demonstrating that cognitive rehabilitation is effective in supporting everyday functioning, reducing disability, and delaying institutionalization [11–15]. …”

Section: How Can Cognitive Rehabilitation Benefit People With Dementimentioning

confidence: 99%

Rehabilitation for people living with dementia: A practical framework of positive support

Clare

2017

PLoS Med

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Group and individual cognitive therapies in Alzheimer's disease: the ETNA3 randomized trial

Cited by 107 publications

References 32 publications

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials

Cognitive Therapy for Dementia Patients: A Systematic Review

Rehabilitation for people living with dementia: A practical framework of positive support

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