P-016: Cognitive performance improves in patient with depression and early dementia during four years of combined treatment: A case study

Abstract

For the last decade the emerging data about brain plasticity showed the possibility of cognitive rehabilitation for medically ill people with signs of depression and dementia. We postulate that people suffering from cognitive deficit and depression, have room for rehabilitation and prevention of memory loss. Based on this suggestion, an integrated treatment protocol was developed in our center. The presented person was a man 67 years old at the first presentation and was 71 years old at the last evaluation. He has 7 years of education. Patient was assessed with the neuropsychological battery which targeted memory, attention and frontal lobe domains at the initial evaluation, 12, 24, 36, and 48 months of the treatment. Protocol consists of medications (Buproprion and Rivastigmine) as well as vitamins and supplements (Multivitamins, Vitamin E, alpha- Lipolic Acid, Coenzyme Q-10 and others), diet and lifestyle modifications, mild sensory-motor and breathing exercises. By the end of 48 months, there were no significant changes on MMSE (27). On Neurobehavioral Status Exam there were improvements in attention, naming, construction, and memory. On Ruff Light Trail Learning Test there were improvements in learning part of the test (from 87 at base line to 101 by the end of 48 months), as well as immediate and delay memory (from 5 to 13 and from 10 to 13 accordingly). There was no decline in 5 minutes recall on Word List Memory Test. Letter and Category Fluency Tests have shown an improvement as well. On Ruff Frontal Fluency Test number of Unique Design increased from 26 (base line) to 41 (48 months), with perseverations level remaining the same. On Wisconsin Card Sorting Test there was an increase in total correct responses (from 47 at base line to 73 by the end of 48 months) with decrease in total errors, perseverative responses, perseverative and non-perseverative errors. Integrated treatment preserved memory decline and increased cognitive performance in patient with mild dementia and depression by the end of 4 years.