The Effectiveness of Reality Orientation in the Treatment of Alzheimer’s Disease

Abstract

Alzheimer's disease (AD) is the most frequent cause of dementia. This work aims to assess the effectiveness of reality orientation (RO), a traditional, extensively documented cognitive enhancement technique, when combined with acetylcholinesterase inhibitors in the treatment of AD. Fourteen patients with AD having mild to moderate dementia receiving standard treatment with donepezil were randomly assigned to control and treatment groups. Patients in the treatment group were submitted to weekly RO sessions for 6 months. Cognitive outcomes were assessed based on scores in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery and the Clock Drawing Test (CDT). Mean CERAD neuropsychological battery, Mini-Mental State Examination (MMSE), and CDT scores improved in the treatment group and worsened in the control group. A number of CERAD neuropsychological battery and MMSE scores were statistically significant. Our findings suggest that RO is a valuable long-term complementary intervention for dementia in AD.

Non-Pharmacological Approaches in the Treatment of Dementia

“…Reality orientation (RO) is a technique of cognitive stimulation [39,40]. It entails presenting the patient by continuous memory and orientation information associated with personal environment and issues.…”

“…It entails presenting the patient by continuous memory and orientation information associated with personal environment and issues. Several methods of implementing RO have been explained [40][41][42]. Throughout the treatment sessions, the patient is supported to talk about various arguments linked to his daily routine and recent events.…”

“…Throughout the treatment sessions, the patient is supported to talk about various arguments linked to his daily routine and recent events. Encouraging the patient to connect socially is a very significant component of the therapy [40,42,43]. Following the first publication of a review about RO, interest in the subject increased dramatically and most subsequent articles reported substantial benefits following the use of these strategies [40,42,44].…”

“…RO focuses on new cognitive stimulation strategies emerged in recent studies. The cognitive stimulation therapy (CST) is an example [40,45]. Beyond the features assessed in RO, the CST is based also on multi-sensory stimulation and reminiscence [40,44,46].…”

Transcranial Pulse Stimulation with Ultrasound in Alzheimer’s disease – A new navigated focal brain therapy

“…word fluency) was used for testing neuropsychological functions. The CERAD is well suited for mild dementia evaluations since it does not show repetition effects with mild AD(Camargo et al 2015, Matthews et al 2013. Additionally, the CERAD highly correlates with other global cognitive and functional scales including ADAS-COG(Seo et al 2010).…”