title: Beneficial Effects of an Integrated Psychostimulation Program in Patients with Alzheimer's Disease.
abstract: BACKGROUND
  The existing pharmacological treatments for Alzheimer's disease (AD) can only slow the progression of symptoms or delay admission to long-term care facilities. The beneficial effects of non-drug treatments are poorly studied.
  
  
  OBJECTIVE
  To describe the effects of an Integrated Psychostimulation Program (IPP) in patients with mild-moderate AD treated with acetylcholinesterase inhibitors; and to identify factors related to greater benefit of the IPP.
  
  
  METHODS
  206 patients (mean age = 75.9 years; MMSE = 19.6) were evaluated before starting the IPP and 3, 6, 9, and 12 months later. Measures included: Mini-Mental State Examination (MMSE), Cognitive Subscale of Alzheimer's Disease Assessment Scale (ADAS-Cog), Rapid Disability Rating Scale (RDRS-2), and Neuropsychiatric Inventory Questionnaire (NPI-Q).
  
  
  RESULTS
  Patients remained cognitively stable (MMSE/ADAS-Cog) for more than 6 months and significantly worsened at 9-month and 12-month follow-ups, without clinically significant functional changes (RDRS-2) or psychiatric symptoms(NPI-Q). The mean annual change on MMSE and ADAS-Cog were 2.06 and 3.56 points, respectively, lower than the annual decline demonstrated previously in similar patients (2.4 and 4.5, respectively). 42.7% of patients maintained or improved global cognitive scores between baseline and 12-month follow-up. The patients who maintained cognitive functions were older than those who did not (77.5 versus 74.7 years).
  
  
  CONCLUSIONS
  The IPP may be an effective treatment to maintain cognition, functionality, and psychiatric symptoms in AD patients pharmacologically treated, and older age seems to increase beneficial effects of IPP.
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Ibarria
authors.affiliation: Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Alegret
authors.affiliation: Department of Psychiatry, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain.|Hospital Universitari Vall d'Hebron -Institut de Recerca, Universitat Autònoma de Barcelona (VHIR-UAB), Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Valero
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Amèrica
authors.initials: A
authors.lastname: Morera
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Guitart
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Cañabate
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Mariola
authors.initials: M
authors.lastname: Moreno
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Lara
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Diego
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Hernández
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Natàlia
authors.initials: N
authors.lastname: Tantinyá
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.
authors.forename: Maribel
authors.initials: M
authors.lastname: Vera
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Hernández
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
authors.affiliation: Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Ruíz
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Boada
authors.affiliation: Alzheimer Center Educational, Day Care Centers of Fundació ACE, Barcelona, Spain.|Memory Clinic of Fundació ACE, Institut Catalá de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Tárraga
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003071:Cognition / Q000502:physiology*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Alzheimer’s disease; Integral Psychostimulation Program; cognition; cognitive stimulation; dementia; functionality; non-pharmacological therapy