Senile Dementia: Combined Pharmacologic and Psychologic Treatment

Yesavage, Jerome A.; Westphal, J. A.; Rush, Leonard

doi:10.1111/j.1532-5415.1981.tb01759.x

Cited by 72 publications

(18 citation statements)

References 23 publications

(22 reference statements)

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“…Among more 'cognitive-specific' intervention we can consider techniques of cognitive remediation and training, which are based on stimulation of functions relatively spared in the first phases of AD. Some reports of positive results can be found in literature for these techniques (Beck, Heacock, Mercer, Thatcher, & Sparkman, 1988;McEvoy & Patterson 1986;Yesavage, Westphal, & Rush, 1981;Zarit, S.H., Zarit, J.M., & Reever, 1982), but, again, results were not conclusive (Clare, Woods, Moniz Cook, Orrell, & Spector, 2003).…”

mentioning

confidence: 78%

Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one?

Farina

Mantovani

Fioravanti

et al. 2006

Aging & Mental Health

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This study evaluated the efficacy of two different group procedures of non-pharmacological treatment in mild-to-moderate Alzheimer's disease (AD). Thirty-two patients entered the study and were divided in groups of four subjects. We compared recreational activities ('global' stimulation) with a combination of procedural memory training on activities of daily living and neuropsychological rehabilitation of 'residual' functions ('cognitive-specific'). All patients and caregivers were ensured psychological support. Both group treatments were delivered for six weeks. Multidimensional efficacy assessment of functional, behavioural and neuropsychological aspects was performed. Patients receiving 'global' stimulation showed a substantial reduction in behavioural disturbances (Neuropsychiatric Inventory [NPI]: frequency p = 0.034; severity p = 0.012); Revised Memory Behaviour Problems Checklist (frequency p = 0.008; reaction p = 0.027), and better performance in the Functional Living Skills Assessment (FLSA), a standardized direct measure of performance in everyday life (p = 0.021) and Verbal Fluency for Letters (p = 0.000). Patients receiving 'cognitive-specific' treatment improved only on the scale evaluating functional competence in daily living (Nurses' Observation Scale for Geriatric Patients [NOSGER] p = 0.018). At follow-up (six months later), compared with baseline, patients following the 'global' stimulation treatment showed an improvement at caregiver distress on NPI (p = 0.04). No other significant difference was detected. Our results support the contention that a 'global' treatment can lead to a significant improvement in AD patients, both for behavioural and functional aspects. The 'cognitive-specific' treatment we used in this research did not show better efficacy.

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mentioning

confidence: 78%

Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one?

Farina

Mantovani

Fioravanti

et al. 2006

Aging & Mental Health

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“…Clinical studies have indicated improved cognitive function in relation to patients under placebo [21,22], Nootropic substances and enhancers of brain activity such as pyritinol [23,24] are often used for symptomatic treatment of AD, and they may be effective by their acti vation of brain metabolism. In analogy to the positive influence of memory training on forgetfulness in higher age [25], cognitive training programs may also be utilized in AD, and their efficacy might be enhanced by drugs sta bilizing neuronal metabolism [26]. Therefore, a con trolled parallel group pilot study was designed in which the effectiveness of PS plus cognitive training was com pared with cognitive training alone, cognitive training plus pyritinol, and with social support alone.…”

mentioning

confidence: 99%

Long-Term Effects of Phosphatidylserine, Pyritinol, and Cognitive Training in Alzheimer's Disease

Heiss¹,

Kessler²,

Mielke³

et al. 1994

Dement Geriatr Cogn Disord

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70 patients with probable Alzheimer''s disease were randomly allocated to four groups: 17 patients received only social support, 18 cognitive training twice a week, in 17 cognitive training was combined with pyritinol 2 x 600 mg/day and in 18 cognitive training was combined with phosphatidylserine 2 x 200 mg/day. Treatment duration was 6 months. Before and after treatment, the patients underwent neuropsychological testing as well as measurement of the regional cerebral metabolic rate for glucose using positron emission tomography and ¹⁸F-2-fluoro-2-deoxy-D-glucose. Before treatment the groups were comparable in respect to resting and activated glucose pattern achieved by a visual recognition task. Electrophysiological changes were assessed as EEG power, globally and in 4 frequency bands. This 6-month study in four groups of patients with Alzheimer''s disease indicated that phosphatidylserine treatment has an effect on different measures of brain function. Since neuropsychological improvements were best documented after 8 and 16 weeks and faded towards the end of the treatment period, it must be concluded that this symptomatic therapy is mainly of short-term benefit and was overcome by the progressive pathological changes at the end of the treatment period.

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“…Further, she or he needs to remember the strategy over some significant period of time. Thus, it is not surprising that research has typically shown negative results when these strategies have been applied to persons with adementing disorder (Becket al, 1985;Yesavage et al, 1981;Zarit et al, 1982).…”

Section: Supporting Everyday Activities In Dementia Staffan Josephssonmentioning

confidence: 96%

Supporting Everyday Activities in Dementia

Josephsson

1996

Int. Psychogeriatr.

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Dementing disorders such as Alzheimer's disease have an enormous impact on the everyday life of the person affected, on his or her family members, and on the staff involved in providing daily care (Borell, 1992). Cognitive dysfunction resulting from dementing diseases, such as memory problems, interferes greatly with the performance of most activities of daily living. The field of occupational therapy has developed a variety of intervention programs addressing everyday activities for persons with dementia. A review of the relevant literature shows, however, that even if the need for such interventions is acknowledged (Porszt-Miron et al., 1988) and an outline for the intervention is described (Bryant, 1991; Rogers et al., 1987), there are few studies evaluating the efficacy and functional relevance of such interventions. Consequently, one urgent task for research is to identify and evaluate intervention strategies addressing occupational functioning among persons with dementia disorders.

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Senile Dementia: Combined Pharmacologic and Psychologic Treatment

Cited by 72 publications

References 23 publications

Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one?

Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a ‘global’ stimulation and a ‘cognitive-specific’ one?

Long-Term Effects of Phosphatidylserine, Pyritinol, and Cognitive Training in Alzheimer's Disease

Supporting Everyday Activities in Dementia

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