A Randomized Cross-over Controlled Study on Cognitive Rehabilitation of Instrumental Activities of Daily Living in Alzheimer Disease

作者：Thivierge Stephanie; Jean Leonie; Simard Martine^*

来源：American Journal of Geriatric Psychiatry, 2014, 22(11): 1188-1199.

DOI：10.1016/j.jagp.2013.03.008

• Alzheimer disease
• cognitive rehabilitation
• errorless learning
• spaced retrieval
• instrumental activities of daily living

Objective: The goal of the study was to investigate the effectiveness of a memory rehabilitation program to re-learn instrumental activities of daily living (IADLs) in patients with Alzheimer disease (AD). Design: This was a 6-month block-randomized cross-over controlled study. Setting: All evaluation and training sessions were performed at each patient%26apos;s home. Participants: Twenty participants with mild to moderate AD. Intervention: The trained IADL was chosen by the patient and his/her caregiver in order to target the patient%26apos;s needs and interests. Participants were trained twice a week for 4 weeks with the errorless learning (ELL) and spaced retrieval (SR) cognitive techniques. After training, there were several follow-ups over a period of at least 3 months. Measurements: Performance on the trained IADL was assessed by a Direct Measure of Training (DMT), an observational instrument adapted from a well-validated scale. General cognitive function, everyday memory functioning, quality of life, neuropsychiatric symptoms and ADL/IADL of patients, as well as the caregiver%26apos;s burden were assessed as secondary outcomes. Results: A statistical significant difference was found between the trained and untrained groups on the DMT immediately following the intervention. Improvements were maintained for a 3-month period. The training did not have effects on any other measures. Conclusions: The present study showed that it is possible for AD patients to relearn significant IADLs with the ELL and SR techniques and to maintain these gains during at least 3 months. The findings of this study emphasize the importance to design robust but individualized intervention tailored on patients%26apos; particular needs.

• 出版日期2014-11