Acetylcholinesterase inhibitors and cognitive stimulation, combined and alone, in treating individuals with mild Alzheimer\u2019s disease

Maria Devita,Pasquale Anselmi,Daniela Mapelli,Giuseppe Sergi,Alessandra Coin,Fabio Masina

doi:10.1007/s40520-021-01837-8

Maria Devita, Pasquale Anselmi + Show 4 more

Open Access

https://doi.org/10.1007/s40520-021-01837-8

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Abstract

BackgroundsAcetylcholinesterase inhibitors (AChEI) and cognitive stimulation (CS) are the standard pharmacological and non-pharmacological treatments for Alzheimer’s disease (AD).AimsThe aim of this study was to investigate the effects of these treatments, alone or combined, on the neuropsychological profiles of patients with AD.MethodsForty participants were assigned to three groups receiving either only AChEI (n = 14), AChEI + CS (n = 15), or only CS (n = 11). Cognition was evaluated at baseline and after three months. Linear mixed-effects models were used to investigate differences among the treatments in terms of changes in the patients’ neuropsychological profiles.ResultsResults, although preliminary because of the small sample size, suggest that a general improvement was found in patients who received AChEI + CS and those who received only CS compared with those who received only AChEI. Interestingly, individuals who received only CS showed a significant improvement in immediate memory recall than those who received only AChEI. Furthermore, the group receiving AChEI + CS showed an improvement in delayed recall than the other two groups.DiscussionThe combination of AChEI and CS seems to have the greatest benefit for patients with mild AD. More interestingly, CS alone is more effective than AChEI alone, even in improving memory, considered to be the “lost” cognitive domain in AD.

Highlights

Extensive data support the use of acetylcholinesterase inhibitors (AChEI), including donepezil, rivastigmine, and galantamine, for treating Alzheimer’s disease (AD) [1, 2]
The aim of the present study was to investigate the effects of AChEI and cognitive stimulation (CS) treatments, administered alone or combined, on the neuropsychological profiles of patients with mild AD
The inclusion criteria were: a diagnosis of probable AD; a mini mental state examination (MMSE) score of 21–25/30; the ability to communicate and understand verbal and written language; the ability to physically participate in a meaningful assessment and a cognitive stimulation program

Summary

Introduction

Extensive data support the use of acetylcholinesterase inhibitors (AChEI), including donepezil, rivastigmine, and galantamine, for treating AD [1, 2]. A growing number of studies and an increasing awareness on the part. Aging Clinical and Experimental Research extent been obtained with pharmacological and non-pharmacological interventions [7]. While AChEI is a recognized and widely used pharmacological treatment, there is still wide variability in the implementation of non-pharmacological interventions (which are sometimes poorly structured). The aim of the present study was to investigate the effects of AChEI and CS treatments, administered alone or combined, on the neuropsychological profiles of patients with mild AD. We hypothesized that an association of AChEI and CS would be the most effective treatment in slowing down cognitive deficiencies

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