Abstract
Alzheimer's disease (AD) presents with significant neuropsychological deficits. Cognitive training in AD has recently started to demonstrate its efficacy. In this study, we implemented computerized cognitive training of a large group of early-stage AD patients, to identify its effects at a neuropsychological level and to investigate whether they were stable after 6 months. Overall, 80 AD patients were randomized in two groups. Patients in the experimental group used a structured rehabilitative software three times a week for 12 consecutive weeks aimed at training memory, attention, executive function and language skills, whereas patients in the control group underwent a control intervention. A Repeated Measures General Linear Model considering groups' performance at the three assessment points (before training, after training and at the 6-month follow-up) showed a significant interaction effect for: digit span forward (F(2,74)=2.785, p=0.03) and backward (F(2,74)=3.183, p=0.02), two-syllable words test (F(2,74)=3.491, p=0.004), Rivermead Behavioural Memory Test immediate (F(2,74)=2.877, p=0.03) and delayed (F(2,74)=3.783, p=0.003), Token test (F(2,74)=4.783, p=0.001), and Brixton test (F(2,74)=8.783, p<0.001). For all of them, experimental group performed better than controls. Patients in the experimental group showed a significant improvement in various neuropsychological domains, and their achievements were stable after 6 months. This study suggests an useful computerized training in AD, and should prompt further investigations about the generalizability of patients' acquired skills to more ecologically oriented tasks.
Highlights
Alzheimer’s disease (AD) presents with significant neuropsychological deficits
Our twofold aim was to identify the effects of the computerized structured cognitive training in the experimental group as compared to controls at a neuropsychological level, and to investigate whether its effects were stable after 6 months
Clinical study we recruited a large group of early-stage AD patients (N=80), performed a detailed neuropsychological assessment, and randomly assigned them to two groups: an experimental group (N=40) undergoing a computerized structured cognitive intervention tailored on the most vulnerable cognitive functions to early-stage AD, and a control group (N=40) undergoing a computerized general cognitive intervention not tailored on patients’ cognitive needs
Summary
Alzheimer’s disease (AD) presents with significant neuropsychological deficits. Cognitive training in AD has recently started to demonstrate its efficacy. In this study we implemented computerized cognitive training of a large group of early-stage AD patients, to identify its effects at a neuropsychological level and to investigate whether they were stable after 6 months. Patients in the experimental group showed a significant improvement in various neuropsychological domains, and their achievements were stable after 6 months. The rationale for cognitive training in AD is based on evidence regarding the neuropsychology and neuroanatomy of memory impairments in AD and the capacity of the patients with AD to acquire new knowledge (Clare et al, 2001; Cavallo et al, 2013a; Cavallo et al, 2016). It is relevant to note that converging evidence clearly indicates that some cognitive subsystems (e.g. procedural memory) remain relatively intact, whilst others (e.g., episodic memory) are dramatically impaired (Salmon & Bondi, 2009; Pause et al, 2013). These dissociations are supported by a developing understanding of the role played by different brain areas in the cognitive processes of memory encoding, storing and retrieval (Glisky, 1998; Graham & Hodges, 1997; Nadel & Moscovitch, 1997)
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