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F2‐01‐03: COMPUTER‐SUPPORTED PERSONAL INTERVENTIONS FOR OLDER PEOPLE WITH COGNITIVE IMPAIRMENT AND DEMENTIA
Author(s) -
Dwolatzky Tzvi,
Tractinsky Noam,
SarneFleischmann Vardit
Publication year - 2014
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.2014.04.137
Subject(s) - dementia , cognitive training , psychological intervention , cognition , reminiscence , randomized controlled trial , psychology , intervention (counseling) , cognitive decline , clinical psychology , gerontology , medicine , physical therapy , psychiatry , disease , surgery , pathology , cognitive psychology
examined whether 1) MCI patients could independently use MST, 2) MST was more effective than spaced retrieval training (SRT), 3) prefrontallybased cognitive control regions were critical for MST success. Methods: Sixty patients with MCI were randomly assigned to MST or SRT. Participants completed five sessions within 2 weeks. During sessions 1 and 5, participants underwent fMRI scanning during both the encoding and retrieval of object location associations. During sessions 2-4, MST participants were taught a 3-step process where they attended to a salient environmental feature, developed a verbally-based reason linking the feature and object, and then created a mental image. The SRT group was matched on number of stimulus exposures and recalled the location of each object after progressive delays of 0-128 seconds. Participants completed a follow-up memory test at 1-month. Results: During training, MST patients independently developed cues on over 80% of the trials. Both groups were highly accurate in recalling the location of objects after a single trial and after the final (9 th) learning trial (all >90% correct). However, MST patients were significantly more accurate than SRT patients during both the posttraining (Cohen’s d1⁄41.03) and 1-month (d1⁄40.83) memory tests. Increased accuracy was inversely related to both the severity of memory impairment and medial temporal lobe atrophy in the MST but not SRT group. The MST group also demonstrated increased activation (postrelative to pretraining) within a number of brain regions, including the PFC.Conclusions: Combined with earlier work, these findings indicate that MST is more appropriate for "early" (i.e., patients closer to "healthy") than "late" MCI patients (i.e., patients closer to dementia). Although comparatively less effective in the long-term, SRT and other rehearsal-based approaches are appropriate regardless of MCI severity. While both approaches capitalize on neuroplasticity, MST preferentially engages cognitive control regions.