Eeva-Liisa Kallio1,2, Hannareeta Öhman1,3, Marja Hietanen2, Helena Soini4, Timo E Strandberg5,6, Hannu Kautiainen1, Kaisu H Pitkälä1. 1. Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland. 2. Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. City of Helsinki, Hospital, Rehabilitation, and Care Services, Helsinki, Finland. 4. City of Helsinki, Social Services and Health Care Department, Helsinki, Finland. 5. University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 6. Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Abstract
OBJECTIVES: To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia. DESIGN: Single-blind randomized controlled trial with 3- and 9-month follow-up. SETTING:Adult day care centers in Helsinki, Finland. PARTICIPANTS: 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). INTERVENTION: 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 45 minutes, and the control group (n = 71) attended day care as usual. MEASUREMENTS: 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 9 months. RESULTS: 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 3 months, 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. CONCLUSION:Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.
RCT Entities:
OBJECTIVES: To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia. DESIGN: Single-blind randomized controlled trial with 3- and 9-month follow-up. SETTING: Adult day care centers in Helsinki, Finland. PARTICIPANTS: 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). INTERVENTION: 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 45 minutes, and the control group (n = 71) attended day care as usual. MEASUREMENTS: 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 9 months. RESULTS: 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 3 months, 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. CONCLUSION: Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.
Authors: Taylor J Krivanek; Seth A Gale; Brittany M McFeeley; Casey M Nicastri; Kirk R Daffner Journal: J Alzheimers Dis Date: 2021 Impact factor: 4.472