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P3‐414: Improvement of functional status after cognitive activation therapy (CAT) in Alzheimer's disease patients
Author(s) -
Gollin Donata,
Ferrari Arianna,
Talassi Erika,
Peruzzi Anna,
Ruaro Cristina,
Codemo Alessandra,
La Sala Angela,
Poli Sarah,
Chiamenti Andrea Maria,
Gabelli Carlo
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1857
Subject(s) - memantine , dementia , cognition , disease , psychology , rivastigmine , everyday life , medicine , clinical psychology , donepezil , neuroscience , political science , law
Background: Non-pharmacological approaches have been shown to be useful to treat cognitive decline in dementia, however the functional impact of such protocols has not been fully established. Aim of the study is to quantify the efficacy of CAT on functional status of subjects with mild to moderate Alzheimer’s Disease (AD). Methods: CAT protocol was developed starting from previous experiences: Reality Orientation Therapy, Reminiscence, errorless learning principles with the addition of social educational animation. The treatment, divided in 18 sessions of 4 hours each, was organized in a small group of patient (3-5). In order to evaluate the effect on simple and complex abilities of everyday life we used the Direct Assessment of Functional Status (DAFS) at the beginning and at the end of each treatment. The activities evaluated by the DAFS were different from the abilities trained during the CAT. Cognitive changes and perceived health status were tested withMMSE and SF-12 respectively. 206 patients in stable treatment with cholinesterase inhibitors or memantine (3monthsminimum)were recruited (MMSE score 14-24). The CAT group (206) was compared with a control group (40) with similar age, gender, functional and cognitive status, and drug therapy. The statistical elaboration was performed using the SPSS package. Results: After CATa significant improvement both of MMSE and DAFS scores was observed: 1.462.6 points (m6SD; p < .0001), and 6.966.2 points (m6SD; p < .0001) respectively. In contrast, in the control group no significant change in MMSE and DAFS was observed and the comparison between the two groups was highly significant for both scales (p < 0.0001). The graphic shows further analisys of the distribution of variation of the DAFS score after treatment. Most of the CAT group had a shift toward the improvement (86.3% from1 to24 points),while theDAFSvariation in the control groupwas distributed around the zero area.Nodifference in the of SF-12 score was found in two groups. CAT protocol was found effective toameliorate not only cognition but also functional status of subjects with mild to moderate Alzheimer’s Disease and may represent an additional therapeutic strategy in association with pharmacological treatments.