Search Advanced

AIMS Medical Science

2016, Volume 3, Issue 1: 1-14. doi: 10.3934/medsci.2016.1.1
Previous Article Next Article
Research article Special Issues

The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

  • 1.
    SIREN, Neurology Section, Dept. of Medicine, CEMIC University Hospital;
  • 2.
    National Council of Scientific and Technological Research (CONICET), Buenos Aires, Argentina
  • Received: 29 September 2015 Accepted: 02 December 2015 Published: 10 December 2015

  • Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer's Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5).

    Citation: Federerico Filipin, Mónica Feldman, Fernando E. Taragano, María Martelli, Viviana Sánchez, Virginia García, Graciela Tufro, Silvina Heisecke, Cecilia Serrano, Carol Dillon. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study[J]. AIMS Medical Science, 2016, 3(1): 1-14. doi: 10.3934/medsci.2016.1.1

    Related Papers:

  • Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5) and dementia (CDR = 1). Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions) were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5). Patients were grouped as 11 amnesic mild cognitive impairment (aMCI), 23 multi domain mild cognitive impairment (mMCI) and 8 Mild Alzheimer's Dementia (CDR 1). None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ) into two groups: low (IQ < 98.5) and high (IQ > 98.5). Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05). Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural improvement can be reported in these patients after the stimulation program (duration time: 12.53 months SD 5.5).


    加载中
    [1] Pagés Larraya F, Grasso L, Marí G (2004) Prevalencia de las demencias del tipo Alzheimer, demencias vasculares y otras demencias del DSM-IV y del ICD-10 en la República Argentina. Rev Neurol Argent 29: 148-153.
    [2] Raschetti R, Albanese E, Vanacore N, et al. (2007) Cholinesterase inhibitors in mild cognitive impairment: a systematic review of randomised trials. PLoS Med 4: e338
    [3] Clare L, Woods R, Moniz Cook E, et al. (2003) Cognitive rehabilitation and cognitive training for early stage Alzheimer's disease and vascular dementia. Cochrane Database of Syst Rev.
    [4] Clare L, Woods R (2004) Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer's disease: a review. Neuropsychol Rehabil 14: 385-401.
    [5] Loewenstein D, Acevedo A, Czaja S, et al. (2004) Cognitive rehabilitation of mildly impaired Alzheimer's disease patients on cholinesterase inhibitors. Am J Geriatr Psychiatry 12: 395-402.
    [6] Davis R, Massman P, Doody R (2001) Cognitive intervention in Alzheimer Disease: a randomized placebocontrolled study. Alzheimer Dis and Assoc Disord 15: 1-9.
    [7] Wilson B (2002) Towards a comprehensive model of cognitive rehabilitation. Neuropsychol Rehabil 12: 97-110. doi: 10.1080/09602010244000020
    [8] Woods B, Aguirre E, Spector AE, et al. (2012) Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database of Syst Rev.
    [9] Wayne A (2003) Evaluating medication effects outside of clinical trials: new-user designs. Am J Epidemiol 158: 915-920. doi: 10.1093/aje/kwg231
    [10] Hughes P, Berg L, Danziger W, et al. (1982) A new clinical rating scale for the staging of dementia. Br J Psychiatry 140: 566-572. doi: 10.1192/bjp.140.6.566
    [11] Petersen R, Doody R, Kurz A, et al. (2001) Current concepts in mild cognitive impairment. Arch Neurol 58:1985-1992. doi: 10.1001/archneur.58.12.1985
    [12] Petersen R (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256: 183-194. doi: 10.1111/j.1365-2796.2004.01388.x
    [13] American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th ed. Washington DC: American Psychiatric Pub.
    [14] McKhann G, Drachman D, Folstein M, et al. (1984) Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34: 939-944. doi: 10.1212/WNL.34.7.939
    [15] Allegri RF, Taragano FE, Krupitzki H, et al. (2010) Role of cognitive reserve in progression from mild cognitive impairment to dementia. Dement Neuropsychol 4:28-34
    [16] Rey A (1964) L'examen Clinique En Psychologic. Paris, France: Presses Universitaires de France.
    [17] Reitan RM (1958) Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills 8: 271-276. doi: 10.2466/pms.1958.8.3.271
    [18] Rey A (1959) Test de copie d'une figure complexe: Manuel. Paris, Les Éditions du Centre de psychologie appliquée.
    [19] Kaplan EF, Goodglass H, Weintraub S (1983) The Boston Naming Test, 2nd edn. Philadelphia, PA: Lea and Febiger.
    [20] Butman J, Allegri RF, Harris P, et al. (2000) Fluencia verbal en español. Datos normativos en Argentina. Medicina 60: 561-564.
    [21] Wechsler D (1997) WAIS III Administration and Scoring Manual. Texas: The Psychological Corporation.
    [22] Wechsler D (1999) Wechsler Abbreviated Scale of Intelligence (WASI). Texas: The Psychological Corporation.
    [23] Zigmond A, Snaith R (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67: 361-370. doi: 10.1111/j.1600-0447.1983.tb09716.x
    [24] McNair D, Kahn E (1983) Self assessment of cognitive deficits. En: Crook T, editor. Assessment in geriatric psychopharmacology. New Canaan: Mark Pwley Associates: 137-143.
    [25] Serrano C, Dillon C, Leis A, et al. (2013) Mild cognitive impairment: risk of dementia according to subtypes. Actas Esp Psiquiatr 41: 330-339.
    [26] Petersen R, Smith G, Waring S, et al. (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neuro 56: 303-308. doi: 10.1001/archneur.56.3.303
    [27] Huntley J, Gould R, Liu K, et al. (2015) Do cognitive interventions improve general cognition in dementia? A meta-analysis and metaregression. BMJ Open 5.
    [28] Spector A, Thorgrimsen L, Woods B (2003) Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. Br J Psychiatry 183: 248-254. doi: 10.1192/bjp.183.3.248
    [29] NICE (National Institute for health and Clinical Excellence) (2006) Dementia: Supporting people with Dementia and their cares in Health and social care. NICE Clinical Guidline 42. London UK.
    [30] Rojas G, Villar V, Iturry M, et al. (2013) Efficacy of a cognitive intervention program in patients with mild cognitive impairment. Int Psychogeriatr 5: 825-831.
    [31] Jean L, Bergeron M, Thivierge, S, et al. (2010) Cognitive intervention programs for individuals with mild cognitive impairment: systematic review of the literature. Am J Geriatr Psychiatry 18: 281-296. doi: 10.1097/JGP.0b013e3181c37ce9
    [32] Gates N, Sachdev P, Fiatarone Singh M, et al. (2011) Cognitive and memory training in adults at risk of dementia: a systematic review. BMC Geriatrics 11: 55. doi: 10.1186/1471-2318-11-55
    [33] Belleville S, Gilbert B, Fontaine F, et al. (2006) Improvement of episodic memory in persons with mild cognitive impairment and healthy older adults: evidence from a cognitive intervention program. Dement Geriatr Cogn Disord 22: 486-499 doi: 10.1159/000096316
    [34] Kurz A, Pohl C, Ramsenthaler M, et al. (2009) Cognitive rehabilitation in patients with mild cognitive impairment. Int J Geriatr Psychiatry 24: 163-168. doi: 10.1002/gps.2086
    [35] Rozzini L, Costardi D, Chilovi BV, et al. (2007) Efficacy of cognitive rehabilitation in parients with mild cognitive impairment treated with cholinesterase inhibitors. Int J Geriatr Psychiatry 22: 356-360. doi: 10.1002/gps.1681
    [36] Talassi E, Guerreschi M, Feriani M, et al. (2007) Effectiveness of a cognitive rehabilitation program in mild dementia and mild cognitive impairment: a case control study. Arch Gerontol Geriatr 44:391-399. doi: 10.1016/j.archger.2007.01.055
    [37] Stern Y (2012) Cognitive Reserve in Ageing and Alzheimer's Disease. Lancet Neurol 11: 1006-1012. doi: 10.1016/S1474-4422(12)70191-6
    [38] Tucker A, Stern Y (2011) Cognitive reserve in aging. Current Alzheimer Res 8: 354-360. doi: 10.2174/156720511795745320
    [39] Deary I, Johnson W (2010) Intelligence and education: causal perceptions drive analytic processes and therefore conclusions. Int J Epidemiol 39:1362-1369. doi: 10.1093/ije/dyq072
  • Reader Comments
  • © 2016 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索
AIMS Medical Science

Metrics

Article views(2827) PDF downloads(1372) Cited by(0)

Download PDF
Download XML
Export Citation
Article outline

Figures and Tables

Tables(6)

Other Articles By Authors

Related pages

Tools

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog