Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: a pilot study.
OBJECTIVE
To study the efficacy of cognitive rehabilitation combined with acetylcholinesterase inhibitor (AChE-I) treatment in patients with mild Alzheimer's disease and their relatives.


METHODS
Thirteen patients with mild Alzheimer's disease treated with rivastigmine 6-12 mg/day for more than two months started cognitive rehabilitation training. Before and after the cognitive rehabilitation training patients were assessed through cognitive tests, activities of daily living scale, neuropsychological battery and scales to evaluate caregivers' depressive and anxiety symptoms. Six patients were randomized to a combined treatment group (AChE-I plus cognitive rehabilitation and caregiver support) and seven patients to a control group (AChE-I only) and followed up for five months.


RESULTS
Mini-Mental State Examination (MMSE) scores (p = 0.047) and backward digit span scores (p = 0.018) were significantly different between the groups on follow-up. The combined treatment group showed a better positive treatment effect on cognitive and neuropsychological tests applied to patients and reduction of psychiatric symptoms was observed in their caregivers (nonsignificant).


CONCLUSIONS
Cognitive rehabilitation associated with AChE-I treatment can potentially be useful to stabilize or improve cognitive and functional performance of patients with mild Alzheimer's disease and can reduce caregivers' psychiatric symptoms.
Bottino
Cássio M C
CM
Old Age Research Group (PROTER), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. cbottino@usp.br
Carvalho
Isabel A M
IA
Alvarez
Ana Maria M A
AM
Avila
Renata
R
Zukauskas
Patrícia R
PR
Bustamante
Sonia E Z
SE
Andrade
Flávia C
FC
Hototian
Sérgio R
SR
Saffi
Fabiana
F
Câmargo
Candida H P
CH
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000534:rehabilitation*; D001007:Anxiety; D017028:Caregivers / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D048448:Phenylcarbamates / Q000627:therapeutic use*; D010865:Pilot Projects; D000068836:Rivastigmine; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine