Enhancing memory and activities of daily living in patients with early Alzheimer's disease using memory stimulation intervention: A randomized controlled trial

Abstract

Objective: The objective of this study was to assess the effectiveness of memory stimulation intervention added to donepezil treatment as compared to donepezil alone in patients with early Alzheimer's disease (eAD). Materials and Methods: Patients in the combined treatment group (CTG = 21) received standard dosages of donepezil and weekly memory stimulation activities sessions for 2 months, whereas the treatment as usual group (TAU = 22) received only standard dosages of donepezil. Each session had extensive tasks on memory and its implied practice on instrumental activities of daily living. After 8 sessions, both groups were evaluated for changes in memory and functional outcomes by administering the mini-mental state examination (MMSE), memory (Postgraduate Institute of Memory Scale), and instrumental activities of daily living scale (IADLS). This trial was registered on the Clinical Trials Registry - India (CTRI/2014/04/004550). Results: Statistical analysis was done using independent t-test, which revealed a significant difference between the groups on MMSE, memory, and IADLS post intervention. The MMSE score in the TAU group, while it increased in the CTG group by 4 points. A similar trend was evident in the memory and IADLS scores as well. Effect size in the CTG group was relatively large as compared to the TAU group where the effects were small and negative on some outcomes. Conclusion: The CTG group showed positive treatment effect on cognitive tests suggesting that combined memory stimulation and donepezil treatment has potential to improve the cognitive and functional performance of patients with eAD.