title: Long-term observation of a multicomponent cognitive intervention in mild cognitive impairment.
abstract: BACKGROUND
  Recent studies demonstrated benefits of cognitive intervention in mild cognitive impairment (MCI), but few studies have determined long-term effects on cognition, conversion rate to Alzheimer's disease, and the role of early intervention.
  
  
  METHODS
  A 6-month multicomponent cognitive group intervention was applied in participants with single- or multiple-domain amnestic MCI (defined according to Petersen's criteria). One group (n = 12) received the intervention at the beginning of the study period and was compared with an active control group (n = 12) who received it after an 8-month time lag. Follow-up assessments were conducted at 15 and 28 months (study period was August 2007-December 2009). The primary outcome was change in cognitive function as determined by changes in scores on the Mini-Mental State Examination and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), and the secondary outcomes were change in specific cognitive and noncognitive functions and conversion to Alzheimer's disease (according to DSM-IV/NINCDS-ADRDA criteria and NAI-AA criteria for probable Alzheimer's dementia with increased level of certainty).
  
  
  RESULTS
  Eighteen participants completed the study after 28 months. Long-term data revealed a stable intervention effect on the primary outcome ADAS-cog in the early-intervention group (P = .024). The participants in the later-intervention (control) group appeared to benefit to a lesser extent from the cognitive intervention compared to those who received it earlier. Only participants in the later-intervention group (6 of 12) converted to Alzheimer's disease during the 28-month study period.
  
  
  CONCLUSIONS
  Benefits of our 6-month cognitive intervention on global cognitive status appear to be preserved over extended follow-up periods. Early cognitive intervention may delay conversion to Alzheimer's disease. Findings in a small sample encourage the use of the intervention in larger-scale studies.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT00544856.
authors.affiliation: Department of Neuropsychology, Inn-Salzach Klinikum Psychiatric Hospital, Wasserburg/Inn, Germany. verena.buschert@iskl.de
authors.forename: Verena C
authors.initials: VC
authors.lastname: Buschert
authors.forename: Ina
authors.initials: I
authors.lastname: Giegling
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Teipel
authors.forename: Sabrina
authors.initials: S
authors.lastname: Jolk
authors.forename: Harald
authors.initials: H
authors.lastname: Hampel
authors.forename: Dan
authors.initials: D
authors.lastname: Rujescu
authors.forename: Katharina
authors.initials: K
authors.lastname: Buerger
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D003194:Computer-Assisted Instruction; D018592:Cross-Over Studies; D018450:Disease Progression; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms