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Cognitive Rehabilitation of Mildly Impaired Alzheimer Disease Patients on Cholinesterase Inhibitors

Received September 9, 2003; revised December 23, 2003; accepted February 3, 2004. From the Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL (DAL,AA,RD), and the Department of Psychiatry and Behavioral Sciences and Center on Aging, University of Miami School of Medicine, Miami, FL (DAL,AA,SJC). Send correspondence to David A. Loewenstein, Ph.D., University of Miami Department of Psychiatry, 2nd Floor, MRI Building, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140. e-mail: dloewenstein{at}worldnet.att.net
© 2004 American Association for Geriatric Psychiatry

Objective: The authors evaluated the efficacy of a new cognitive rehabilitation program on memory and functional performance of mildly impaired Alzheimer disease (AD) patients receiving a cholinesterase inhibitor. Methods: Twenty-five participants in the Cognitive Rehabilitation (CR) condition participated in two 45-minute sessions twice per week for 24 total sessions. CR training included face–name association tasks, object recall training, functional tasks (e.g., making change, paying bills), orientation to time and place, visuo-motor speed of processing , and the use of a memory notebook. Nineteen participants in the Mental Stimulation (MS) condition had equivalent therapist contact and number of sessions, which consisted of interactive computer games involving memory, concentration, and problem-solving skills. Results: Compared with the MS condition, participants in CR demonstrated improved performance on tasks that were similar to those used in training. Gains in recall of face–name associations, orientation, cognitive processing speed, and specific functional tasks were present post-intervention and at a 3-month follow-up. Conclusion: A systematic program of cognitive rehabilitation can result in maintained improvement in performance on specific cognitive and functional tasks in mildly impaired AD patients.

Key Words: Cholinesterase Inhibitors • Alzheimer Disease • Cognitive Rehabilitation

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