title: A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in Alzheimer disease.
abstract: OBJECTIVE
  The goal of the study was to investigate the effectiveness of a memory rehabilitation program to re-learn instrumental activities of daily living (IADLs) in patients with Alzheimer disease (AD).
  
  
  METHODS
  This was a 6-month block-randomized cross-over controlled study.
  
  
  METHODS
  All evaluation and training sessions were performed at each patient's home.
  
  
  METHODS
  Twenty participants with mild to moderate AD.
  
  
  METHODS
  The trained IADL was chosen by the patient and his/her caregiver in order to target the patient's needs and interests. Participants were trained twice a week for 4 weeks with the errorless learning (ELL) and spaced retrieval (SR) cognitive techniques. After training, there were several follow-ups over a period of at least 3 months.
  
  
  METHODS
  Performance on the trained IADL was assessed by a Direct Measure of Training (DMT), an observational instrument adapted from a well-validated scale. General cognitive function, everyday memory functioning, quality of life, neuropsychiatric symptoms and ADL/IADL of patients, as well as the caregiver's burden were assessed as secondary outcomes.
  
  
  RESULTS
  A statistical significant difference was found between the trained and untrained groups on the DMT immediately following the intervention. Improvements were maintained for a 3-month period. The training did not have effects on any other measures.
  
  
  CONCLUSIONS
  The present study showed that it is possible for AD patients to relearn significant IADLs with the ELL and SR techniques and to maintain these gains during at least 3 months. The findings of this study emphasize the importance to design robust but individualized intervention tailored on patients' particular needs.
authors.affiliation: École de psychologie, Université Laval, and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec, Quebec, Canada.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Thivierge
authors.affiliation: Département de psychiatrie, Centre hospitalier affilié universitaire de Québec- Hôpital de l'Enfant-Jésus, Quebec, Canada.
authors.forename: Léonie
authors.initials: L
authors.lastname: Jean
authors.affiliation: École de psychologie, Université Laval, and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec, Quebec, Canada. Electronic address: Martine.Simard@psy.ulaval.ca.
authors.forename: Martine
authors.initials: M
authors.lastname: Simard
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology / Q000534:rehabilitation*; D003071:Cognition; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome
keywords: Alzheimer disease; cognitive rehabilitation; errorless learning; instrumental activities of daily living; spaced retrieval