title: Predictors of comprehensive stimulation program efficacy in patients with cognitive impairment. Clinical practice recommendations.
abstract: BACKGROUND
  The aim of the present study was to identify which factors may predict the best response to a comprehensive stimulation program in patients with dementia and mild cognitive impairment (MCI) as well as in their caregivers.
  
  
  METHODS
  A six-month longitudinal study has been performed on 145 patients (55 with MCI and 90 with dementia), participating to a cognitive motor rehabilitation program, and their 131 caregivers, attending informational/psychoeducational interventions. Mini mental state examination, Alzheimer's Disease Assessment Scale-Cognition, and Clinician's Interview-Based Impression of Change-plus were used as primary outcome measures.
  
  
  RESULTS
  Sixty-eight (46.9%) of the 145 subjects were classified as clinical responders. At baseline, responders had a significant less insight impairment, larger functional ability as well as less delusions, euphoria, and aberrant motor behaviors than the non-responder. After 6 months along with an improvement in cognition, responders showed decrease in behavioral disturbances and severity of the disturbances. During the 6 months of analysis, stability has been observed in caregiver's burden distress. After 6 months, the caregivers of MCI responders have their burden reduced.
  
  
  CONCLUSIONS
  The high level of insight, the preserved functional abilities as well as the lack of severe delusions, euphoria, and aberrant motor behaviors are significant predictors of responsiveness to stimulation program.
authors.affiliation: NeuroBioGen Lab-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. gbinetti@fatebenefratelli.it
authors.forename: Giuliano
authors.initials: G
authors.lastname: Binetti
authors.forename: Davide V
authors.initials: DV
authors.lastname: Moretti
authors.forename: Chiara
authors.initials: C
authors.lastname: Scalvini
authors.forename: Giuseppina
authors.initials: G
authors.lastname: di Giovanni
authors.forename: Chiara
authors.initials: C
authors.lastname: Verzeletti
authors.forename: Filippo
authors.initials: F
authors.lastname: Mazzini
authors.forename: Silvia
authors.initials: S
authors.lastname: Valent
authors.forename: Roberta
authors.initials: R
authors.lastname: Ghidoni
authors.forename: Luisa
authors.initials: L
authors.lastname: Benussi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods; D060825:Cognitive Dysfunction / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003704:Dementia / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D011597:Psychomotor Performance / Q000502:physiology; D011788:Quality of Life; D013315:Stress, Psychological