Introduction:
The benefit of cognitive rehabilitation (CR) for patients with early-stage Alzheimer disease (AD) remains difficult to assess.
Method:
An
observational, prospective study was conducted in a sample of 52
patients with AD included in a clinical, individualized CR program.
Cognitive rehabilitation consisted of 1 weekly session during 3 months
at home, followed by 1 monthly contact for 9 months. Rehabilitation
techniques were used by experienced therapists to adapt activities
important for the patient. Evaluation of patient’s dependence in
activities and objective and subjective caregiver’s burden was performed
with a research quantitative scale immediately after the intervention
and at 6-month and 1-year follow-up.
Results:
Analyses
with repeated measure analysis of variance showed decreased patient’s
dependence for adapted activities at 3 months, 6 months, and 1 year.
Objective and subjective percentage of caregiver’s burden was also
decreased at all evaluations with our research functional scale, while
there was no change on Zarit’s burden scale. Global cognition slightly
decreased over 1 year.
Conclusions:
This
observational study in a clinical setting is in line with the benefit
of CR for patients with mild AD reported in recent randomized controlled
trials. The benefit obtained for adapted activities remained after 1
year, even if global cognition declined. Moreover caregiver’s burden
related to all individually relevant daily activities (from a list of
98) evaluated within the CR program was decreased after 1 year. Those
preliminary results emphasize the importance of choice for the
measurement instrument to report CR efficacy and claim for further
validation of such tools.
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