title: The effects of a comprehensive rehabilitation program of Alzheimer's Disease in a hospital setting.
abstract: BACKGROUND
  The evidence for the clinical effectiveness of cognitive rehabilitation in patients with Alzheimer's Disease (AD) is debated. Therefore it is important to collect more evidence about the outcome of non-pharmacological therapy of dementia.
  
  
  METHODS
  We report data concerning the rehabilitation of 50 patients with probable AD admitted during a 17-month period in a specialized unit. Participants were affected by dementia ranging from mild to severe. The patients were treated with the Reality Orientation Therapy (ROT), integrated, when needed, with individualised cognitive approaches. The results concern: the cognitive status, evaluated by means of the Mini Mental State Examination (MMSE), the functional status, evaluated with the Activity of Daily Living (ADL) scale, the assessment of psychological and behavioural disorders measured with the Neuropsychiatry Inventory (NPI). The cognitive, functional, and psychopathological assessments were administered at admission and discharge.
  
  
  RESULTS
  The mean MMSE scores at admission and discharge were respectively 16.06 and 17.54 (Wilcoxon Ranks Test: p=0.005). Mean ADL scores were 4.86 at admission and 5.02 at discharge (p=0.011). Mean NPI scores were respectively 21.46 and 12.26 (p<0.001).
  
  
  CONCLUSIONS
  This survey of the 17-month experience suggests that a comprehensive treatment program may have beneficial effects on cognitive, functional, and in particular neuropsychiatric outcomes. The results should be verified with a randomised clinical trial.
authors.affiliation: Department of Psychology and Neuroscience, Vita-Salute San Raffaele University, Milan, Italy. raggi.alberto@hsr.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.forename: Sandro
authors.initials: S
authors.lastname: Iannaccone
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marcone
authors.forename: Valeria
authors.initials: V
authors.lastname: Ginex
authors.forename: Paola
authors.initials: P
authors.lastname: Ortelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nonis
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Giusti
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Cappa
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009483:Neuropsychological Tests; D009949:Orientation; D011937:Reality Therapy / Q000379:methods*; D012112:Residential Facilities; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric