Neuropsychological outcome of cognitive training in mild to moderate dementia: A randomized controlled trial

Contact Information

Keywords

Eeva-Liisa Kallio, eeva-liisa.kallio@hus.fi

cognition, cognitive training, dementia, executive functions, psychological well-being

Abstract

Effectiveness of a 12-week cognitive training (CT) programme for community-dwelling patients with dementia was evaluated on various cognitive functions (attention, memory, executive functions and reasoning) and psychological well-being (PWB). A single-blind randomized controlled trial was conducted in adult day care centres in Helsinki, Finland. Participants (N = 147) were older individuals with mild to moderate dementia living at home and attending day care (mean age 83 years, 72% female, 63% at mild stage of dementia). The intervention group (n = 76) received systematic CT for 45 min twice a week while the control group (n = 71) attended day care as usual. The cognitive and psychological outcomes were measured at baseline, and followed up at 3 and 9 months. No differences between the two groups in changes of any of the cognitive functions, or PWB over time were found. We observed a positive trend at 3 months in the change for PWB favouring the intervention group, but no significant interaction effect was found (p = .079; d = -0.31). Thus, systematic CT appears to have no effect on neuropsychological outcomes of cognitive functioning and PWB in older adults who already have dementia.

Citation

Kallio, E. L., Hietanen, M., Kautiainen, H., & Pitkälä, K. H. (2021). Neuropsychological outcome of cognitive training in mild to moderate dementia: A randomized controlled trial. Neuropsychological rehabilitation, 31(6), 935–953. https://doi.org/10.1080/09602011.2020.1749674

DOI

10.1080/09602011.2020.1749674

EWB Constructs:

(3) positive affect

EWB Measures:

Psychological well-being: 6 questions about life satis- faction, feeling needed, having plans for the future, having a zest for life, feeling depressed, and suffering from loneliness (Routasalo et al., 2009: This questionnaire charted psychological well-being using six questions used in our previous studies since 1989 (Tilvis et al. 2000). )

data availability:

data availability details:

N/A

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

(1) any terminal disease;
(2) severe loss of communicative ability;
(3) waiting to be institutionalized;
(4) having no available proxy

Inclusion Criteria

(1) AD or other dementia at a very mild, mild or moderate stage (Clinical Dementia Rating scale, CDR, 0.5–2; Hughes et al., 1982)
(2) aged ≥ 65 years;
(3) Finnish-speaking;
(4) able to see, hear, read and write;
(5) living at home; and
(6) attending an adult day care centre at least twice a week.

Non-EWB Behavioral
Measures:

(1) CDR and Mini Mental State Examination
(2) Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)
(3) Attention and processing speed: Trail Making Test (TMT)
(4) Working memory: Finnish Wechsler Memory Scale
(5) Episodic memory: 12-item Word Recognition task of the ADAS-Cog
(6) Reasoning: Verbal concept formation and reasoning (WAIS-IV)

First author:

Eeva-Liisa Kallio

species:

Human

sample size:

147

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

12-week cognitive training (CT)

study population:

(2) patients with (pre)clinical dementia

sex (% female):

72%

ethnicity (%white)

not stated (Finland)

Age (mean, sd):

total: 83.1
intervention: 82.5 (5.5)
control: 83.6 (5.4)

biological/Physiological Measures:

N/A