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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2009 Jun-Jul;24(3):234–245. doi: 10.1177/1533317509332624

Preserving Cognition Through an Integrated Cognitive Stimulation and Training Program

Margie Eckroth-Bucher 1, James Siberski 2
PMCID: PMC10845992  PMID: 19346501

Abstract

Background: Cognitive decline leads to disability and increased health care expenditures. Methods: Effectiveness of an intervention to stimulate multiple cognitive domains was determined using a format combining traditional and computer-based activities (Integrated Cognitive Stimulation and Training Program), 45 minutes a day, 2 days a week, for 6 weeks. Nonimpaired, mildly, and moderately-impaired participants > age 65 (n = 32) were randomly allocated into a control or experimental group. Using a repeated measures design participants were tested again postintervention and at 8 weeks follow-up. Results: Statistically significant improvement on Dementia Rating Scale scores occurred for mildly and moderately impaired treatment participants (n = 15). Statistical significance was demonstrated on subscales of the WMS-III: Logical Memory I and Logical Memory II. Conclusion: Blending computer-based with traditional cognitive stimulation activities shows promise in preserving cognitive function in elders. Future studies to explore efficacy in larger, more diverse samples are needed.

Keywords: cognitive impairment, cognitive stimulation, cognitive training, computer-based training

Full Text

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Contributor Information

Margie Eckroth-Bucher, Department of Nursing, Bloomsburg University, Bloomsburg, Pennsylvania, meckroth@bloomu.edu .

James Siberski, Geriatric Care Manager Program, Misericordia University, Dallas, Pennsylvania.

References

  1. Chertkow H., Massoud F., Nasreddine Z., et al. Diagnosis and treatment of dementia: 3 mild cognitive impairment and cognitive impairment without dementia. Can Med Assoc J . 2008;178:1273-1284. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Jonker C., Launer LJ, Hooijer C., Lindeboom J. Memory complaints and memory impairment in older individuals including commentary by Wilson RS and Evans DA. J Am Geriatr Soc. 1996;44:44-49,93-94. [DOI] [PubMed] [Google Scholar]
  3. Zelinski EM, Burnight KP, Lane CJ The relationship between subjective and objective memory in the oldest old: comparisons of findings from a representative and a convenience sample. J Aging Health. 2001;13:248-266. [DOI] [PubMed] [Google Scholar]
  4. Leirer VO, Morrow DG, Sheikh JI, Pariante GM Memory skills elders want the improve. Exp Aging Res . 1990;16:155-158. [DOI] [PubMed] [Google Scholar]
  5. Levy-Cushman J., Abeles N. Memory complaints in the able elderly . Clin Gerontol. 1998;19:3-24. [Google Scholar]
  6. Pearman A., Storandt M. Self-discipline and self-consciousness predict subjective memory in older adults. J Gerontol. 2005;60B:155-157. [DOI] [PubMed] [Google Scholar]
  7. Valentijn ASM , vanHooren SAH, Bosma H., et al. The effect of two types of memory training on subjective and objective memory performance in healthy individuals aged 55 years and older: a randomized controlled trial . Patient Educ Couns. 2005;57:106-114. [DOI] [PubMed] [Google Scholar]
  8. Ertel KA, Glymour MM, Berkman LF Effects of social integration on preserving memory function in a Nationally representative US elderly population. Am J Public Health. 2008;98:1215-1220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Taylor DH, Schenkman M., Zhou J., Sloan FA The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Geront B Psychol Sci Socl Sci. 2001;56B(5): S285-93. [DOI] [PubMed] [Google Scholar]
  10. Areosa Sastre A., McShane R., Sherriff F. Mematine for dementia . Cochrane Database Syst Rev. 4. [DOI] [PubMed] [Google Scholar]
  11. Birks JS, Harvey R. Donepenzil for dementia due to Alzheimer's Disease. Cochrane Database Syst Rev. 3. [Google Scholar]
  12. Loy C., Schneider L. Galatamine for Alzheimer's Disease. Cochrane Database Syst Rev. 4. [DOI] [PubMed] [Google Scholar]
  13. Fitzsimmons S., Buettner LL Health promotion for the mind, body, and spirit: A college course for older adults with dementia. Am J Alzheimers Dis Other Demen. 2003;18:282-290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Goldsilver PM, Gruneir MRB. Early stage dementia: An innovative model of support for individuals in the early stages of dementia . Am J Alzheimers Dis Other Demen. 2001;16:109-114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Bäckman L. Memory training and memory improvement in Alzheimer's disease: rules and exceptions . Acta Neurol Scand. 1992;193:84-89. [DOI] [PubMed] [Google Scholar]
  16. Bäckman L., Josephsson S., Herlitz A., Stigsdotter A., Vhtanen M. The generalizability of training gains in dementia: effect of imagery-based mnemonic on face-name retention duration. Psychol Aging. 1991;6: 489-492. [DOI] [PubMed] [Google Scholar]
  17. Clare L., Wilson B., Carter G., Hodges J., Adams M. Long-term maintenance of treatment gains following a cognitive rehabilitation intervention in early dementia of Alzheimer type: a single case study. Neuropsychol Rehabil. 2001;11:477-494. [Google Scholar]
  18. Clare L., Wilson B., Carter G., Hodges J. Cognitive rehabilitation as a component of early intervention in Alzheimer's disease: A single case study. Aging Ment Health. 2003;7:15-21. [DOI] [PubMed] [Google Scholar]
  19. Zanetti O., Zanieri G., DiGiovanni G., et al. Effectiveness of procedural memory stimulation in mild Alzheimer's disease patients: a controlled study. Neuropsychol rehabil . 2001;11:263-272. [Google Scholar]
  20. Cummings JF, Benson DF Dementia: A Clinical Approach. 2nd ed. Stoneham, MA: Butterworth-Heinemann; ; 1992. [Google Scholar]
  21. LeDoux J. The synaptic self. How Our Brains Become Who We Are. New York: Penguin Books; 2002. [Google Scholar]
  22. Clare L., Woods B. Cognitive training and cognitive rehabilitation for people with early stage Alzheimer's Disease: a review. Neuropsychol rehabil . 2004;14:385-401. [Google Scholar]
  23. Salthouse TA , Berish DE, Miles JD The role of cognitive stimulation on the relations between age and cognitive stimulation. Psychol Aging. 2002;17:548-557. [DOI] [PubMed] [Google Scholar]
  24. Verghese J. , Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003. ;348:2508-2516. [DOI] [PubMed] [Google Scholar]
  25. Wilson RS, Mendes de Leon CF, Barnes LL, et al. Participation in cognitively stimulating activities and risk of incident Alzheimer's Disease. JAMA. 2002. ;287: 742-748. [DOI] [PubMed] [Google Scholar]
  26. Rockstroh S. , Dietrich B., Pokorny R. Memory and attention test performance of young and elderly subjects after retest practice. Int Psychogeriatr . 1995;7:377-384. [DOI] [PubMed] [Google Scholar]
  27. Singer T., Lindenberger U., Baltes PB Plasticity of memory for new learning in very old age: a story of major loss . Psychol Aging. 2003;18:306-317. [DOI] [PubMed] [Google Scholar]
  28. Schaie KW, Willis SL Can decline in adult intellectual functioning be preserved? Dev Psychol. 1986;22: 223-232. [Google Scholar]
  29. Yang L., Krampe RT, Baltes PB Basic forms of cognitive plasticity extended into the oldest-old: retest learning, age, and cognitive functioning. Psychol Aging . 2006;21: 372-378. [DOI] [PubMed] [Google Scholar]
  30. Gatz M., Fiske A., Fox LS, et al. Empirically validated psychological treatments for older adults . J Ment Health Aging. 1998;4:9-46. [Google Scholar]
  31. De Vreese LP , Neri M., Fioravanti M., Belloi L., Zanetti O. Memory rehabilitation in Alzheimer's disease: a review of progress. Int J Geriatr Psychiatr. 2001;16:794-809. [DOI] [PubMed] [Google Scholar]
  32. Grandmaison E., Simard M. A critical review of memory stimulation programs in Alzheimer's Disease. J Neuropsychiatry Clin Neurosci . 2003;15:130-144. [DOI] [PubMed] [Google Scholar]
  33. Ball K., Berch DB, Helmers KF, et al. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002;288:2271-2280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Willis SL, Tennstedt SL, Marsiske M., et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006;296:2805-2814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Godfrey JR Toward optimal health: the experts discuss memory loss in aging women . J Womens Health. 2004;13:856-862. [DOI] [PubMed] [Google Scholar]
  36. Small G. The Memory Bible. New York: Hyperion; ; 2002. [Google Scholar]
  37. Moore S., Sandman CA, McGrady K., Kesslak JP Memory training improves cognitive ability in patients with dementia . Neuropsychol rehabil. 2001;11:245-261. [Google Scholar]
  38. Sandman CA Memory rehabilitation in Alzheimer's disease: preliminary findings . Clin Gerontol. 1993;13: 19-33. [Google Scholar]
  39. Fritsch T., Smyth KA, Debanne SM, Petot GJ, Friedland RP Participation in novelty-seeking activities and Alzheimer's Disease . J Geriatr Psychiatry Neurol. 2005;18:134-141. [DOI] [PubMed] [Google Scholar]
  40. Morris JM The effects of an introductory computer course on the attitudes of older adults towards computers. ACM Comm. 1992;2:72-75. [Google Scholar]
  41. McContha JT , McContha D., Deaner SL, Dermigny R. A computer based intervention for education and therapy of institutionalized older adults. Educ Gerontol . 1995;21:129-138. [Google Scholar]
  42. Thompson S. Assessing dementia in people with learning disabilities for cognitive rehabilitation. J Cognit Rehabil . 1999;(May/June):14-20. [Google Scholar]
  43. Rasmusson DX , Rebok GW, Bylsma FW, Brandt J. Effects of three types of memory training in normal elderly. Aging Neuropsychol Cogn. 1999;6:56-66. [Google Scholar]
  44. Gunther VK, Schafer P., Holzner BJ, Kemmler GW Long-term improvements in cognitive performance through computer assisted cognitive training: a pilot study in residential home for older people. Aging Ment Health. 2003;7:200-206. [DOI] [PubMed] [Google Scholar]
  45. Bond GE, Wolf-Wilets V., Fiedler FE, Burr RL Computer-aided cognitive training of the aged: a pilot study. Clin Gerontol. 2000;22:19-42. [Google Scholar]
  46. Hofmann M., Hock C., Kuhler A., Muller-Spahn F. Interactive computer-based cognitive training in patients with Alzheimer's disease. J Psychiatr Res. 1996;30:493-501. [DOI] [PubMed] [Google Scholar]
  47. Schreiber M. , Schweizer A., Lutz K., Kalveram KT, Jäncke L. Potential of an interactive computer-based training in the rehabilitation of dementia: an initial study. Neuropsychol rehabil. 1999. ;9:155-167. [Google Scholar]
  48. Hofman M., Rosler A., Schwarz W., et al. Interactive computer-training as a therapeutic tool in Alzheimer's Disease. Compr Psychiatry. 2003;44:213-219. [DOI] [PubMed] [Google Scholar]
  49. Dick JPR , Guiloff RJ, Stewart A. Mini-Mental State examination in neurological patients. J Neurol Neurosurg Psychiatry. 1984. ;47:496-499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Folstein MF , Folstein SE, McHugh PR Mini Mental State. A practical method for grading cognitive states of patients for the clinician . J Psychiatr Res. 1975;12: 189-198. [DOI] [PubMed] [Google Scholar]
  51. Pearson JL, Cherrier M., Teri L. The mini-mental state exam and the mental status questionnaire: depression in Alzheimer's Disease. Clin Gerontol. 1989. ;8:31-37. [Google Scholar]
  52. Saczynski JS , Rebok GW Strategies for memory improvement in older adults. Topics Adv Practice Nurse J [serial on the Internet] . 2004;4 about page 1. Available at: http://www.medscape.com/viewpublication/527_toc?vol=4&iss=1&templateid=2 . Accessed: July 8, 2006. [Google Scholar]
  53. Tombaugh TN, McIntyre NJ The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc. 1992;40:922-935. [DOI] [PubMed] [Google Scholar]
  54. Mattis S. Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources; 1988. [Google Scholar]
  55. Holtzer R., Brurright RG, Donovick PJ Mattis Dementia Rating Scale: performance in the very elderly. Clin Gerontol. 2001;24:107-114. [Google Scholar]
  56. Shay KA, Duke LW, Conboy T., Harrell LE, Callaway T., Folks DG The clinical validity of the Mattis Dementia Rating Scale in staging Alzheimer's disease. J Geriatr Psychiatry Neurol. 1991. ;4:18-25. [DOI] [PubMed] [Google Scholar]
  57. Gardner RF, Oliver-Munoz S., Fisher L., Empting L. Mattis Dementia Rating Scale: Internal reliability study using a diffusely impaired population. J Clin Neuropsychol. 1981;3:271-275. [DOI] [PubMed] [Google Scholar]
  58. Woodward JL , Salthouse TA, Godsall RE, Green RC Confirmatory factor analysis of the Mattis Dementia Rating Scale in patients with Alzheimer's disease. Psychol Assess. 1996;8:85-91. [Google Scholar]
  59. Knox MR, Lacritz LH, Chandler MJ, Cullum CM Association between dementia rating scale performance and neurocognitive domains in Alzheimer's disease. Clin Neuropsychol. 2003;17:216-219. [DOI] [PubMed] [Google Scholar]
  60. Wechsler, D. Wechsler Memory Scale-third edition: administration and scoring manual. San Antonio, TX: The Psychological Corporation; 1997. [Google Scholar]
  61. Beck C., Heacock P., Mercer S., Thatcher R., Sparkman C. The impact of cognitive skills remediation training on person's with Alzheimer's disease or mixed dementia. J Geriatr Psychiatry . 1988;21:73-88. [PubMed] [Google Scholar]
  62. Breuil V., De Rotrou J., Forette F., et al. Cognitive stimulation of patients with dementia: Preliminary results. In J Geriatr Psychiat. 1994;9:211-217. [Google Scholar]
  63. Spector A., Thorgrimsen L., Woods B., et al. Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia. Br J Psychiatry. 2003;183: 248-245. [DOI] [PubMed] [Google Scholar]
  64. Wenish E., Cantegrell-Kallen I., DeRotrou J., et al. Cognitive stimulation intervention for elders with mild cognitive impairment compared with normal aged subjects: preliminary results. Aging Clin Exp Res. 2007;19: 316-322. [DOI] [PubMed] [Google Scholar]
  65. Rapp S., Brenes G., Marsh AP Memory enhancement training for older adults with mild cognitive impairment: a preliminary study. Aging Ment Health. 2002. ;6: 5-11. [DOI] [PubMed] [Google Scholar]
  66. Davis RN, Massman PJ, Dood RS Cognitive intervention in Alzheimer disease: a randomized placebo-controlled study. Am J Alzheimers Dis Other Demen. 2001. ;15:1-9. [DOI] [PubMed] [Google Scholar]
  67. Unverzagt FW , Kasten L., Johnson KE, et al. Effect of memory impairment on training outcomes in ACTIVE. J Int Neuropsychol Soc. 2007;13:953-960. [DOI] [PMC free article] [PubMed] [Google Scholar]
  68. Mahncke HW, Connor BB, Appelman J., et al. Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. PNAS. 2006;13:12523-12528l. [DOI] [PMC free article] [PubMed] [Google Scholar]

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