title: Errorless practice as a possible adjuvant to donepezil in Alzheimer's disease.
abstract: Six individuals with probable Alzheimer's disease (AD) participated in a phase 1 study employing a repeated measures, parallel baseline design testing the hypothesis that error-free experience during word production practice combined with an acetyl cholinesterase inhibitor would improve confrontation naming ability. While acetyl cholinesterase inhibitors are safe and delay cognition decline associated with AD, improvement over baseline cognition is less evident; clinically significant cognitive deficits persist and progress. Both animal and clinical research strongly implicate acetylcholine in learning, a form of neuroplasticity. In clinical practice, however, people with AD are given cholinergic medications without concomitant systematic/targeted retraining. In this study six participants with probable AD and taking donepezil participated in targeted word production practice using an errorless learning strategy. Results showed that combining behavioral enrichment training and an acetyl cholinesterase inhibitor resulted in significant improvements in verbal confrontation naming of trained items for three of six participants. Differences in baseline dementia severity, living conditions, and medications may have influenced the training response. Detection of substantial treatment effects in 50% of subjects suggests further language treatment studies in AD in combination with an acetyl cholinesterase inhibitor are warranted and provide useful information on inclusion/exclusion criteria for use in subsequent studies.
authors.affiliation: Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, Florida 32608-1197, USA. gonzalj@neurology.ufl
authors.forename: Leslie J Gonzalez
authors.initials: LJ
authors.lastname: Rothi
authors.forename: Renee
authors.initials: R
authors.lastname: Fuller
authors.forename: Susan A
authors.initials: SA
authors.lastname: Leon
authors.forename: Diane
authors.initials: D
authors.lastname: Kendall
authors.forename: Anna
authors.initials: A
authors.lastname: Moore
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wu
authors.forename: Bruce
authors.initials: B
authors.lastname: Crosson
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Heilman
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Nadeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010880:Piperidines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil