Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors.
BACKGROUND
Individuals who have Mild Cognitive Impairment (MCI) may be in a transitional stage between aging and Alzheimer's disease (AD). The high rate of conversion from MCI to AD makes early treatment an important clinical issue. Recent evidence suggests that cognitive training intervention may reduce the rate of progression to AD.


OBJECTIVE
To evaluate the efficacy of a NeuroPsychological Training (TNP) in patients with MCI who are treated with cholinesterase inhibitors (ChEIs), compared with patients MCI treated only with ChEIs and patients not treated, in a longitudinal, one year follow-up study.


METHODS
One year longitudinal and retrospective comparison study of neuropsychological performances in 59 subjects affected by Mild Cognitive Impairment (MCI) according to Petersen's criteria. Fifteen subjects were randomised to receive TNP plus cholinesterase inhibitors; 22 subjects cholinesterase inhibitors alone and 22 subjects no treatment. All the subjects referring memory complaints, corroborated by an informant, underwent a multidimensional assessment concerning neuropsychological, behavioural and functional characteristics, at baseline and after one year follow-up.


RESULTS
Subjects without treatment maintained their cognitive, functional and behavioural status after one year; patients treated only with ChEIs improved in depressive symptoms whereas subjects treated with TNP and ChEIs showed significant improvements in different cognitive areas, such as memory, abstract reasoning and in behavioural disturbances, particularly depressive symptoms.


CONCLUSIONS
A long-term TNP in ChEIs-treated MCI subjects induces additional cognitive and mood benefits.
Rozzini
Luca
L
Department of Neurology, University of Brescia, Italy. lrozzini@iol.it
Costardi
Daniela
D
Chilovi
Barbara Vicini
BV
Franzoni
Simone
S
Trabucchi
Marco
M
Padovani
Alessandro
A
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003194:Computer-Assisted Instruction; D000077265:Donepezil; D005260:Female; D005702:Galantamine / Q000627:therapeutic use; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D007360:Intelligence; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000534:rehabilitation; D008875:Middle Aged; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009949:Orientation; D048448:Phenylcarbamates / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D011340:Problem Solving; D012189:Retrospective Studies; D000068836:Rivastigmine; D012984:Software; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine