Effects of Cognitive Training on Cognition and Quality of Life of Older Persons with Dementia.

Abstract

To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia. Single-blind randomized controlled trial with 3- and 9-month follow-up. Adult day care centers in Helsinki, Finland. Older individuals with mild to moderate dementia living at home and attending adult day care twice a week (N=147; mean age 83, 72% female, 63% at mild stage of dementia). A systematic 12-week training program focused on subskills of executive function: attention, working memory, cognitive flexibility, and planning. The intervention group (n=76) underwent cognitive training twice a week for 45minutes, and the control group (n=71) attended day care as usual. Primary outcomes were the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) for global cognition and the 15-dimensional instrument (15D) for HRQoL. The outcomes were measured at baseline and 3 and 9months. Both groups deteriorated in global cognition and HRQoL during follow-up, and there were no differences between the two groups in change on the ADAS-Cog (P=.43) or 15D (P=.61) over time (adjusted for age and sex). At 3months, changes were 0.8 (95% confidence interval (CI)=-0.2-1.8) for the intervention group and 1.7 (95% CI=0.6-2.7) for the control group on the ADAS-Cog and -0.040 (95% CI=-0.058 to -0.021) for the intervention group and -0.037 (95% CI=-0.056 to -0.018) for the control group on the 15D. Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.