Efficacy of Cognitive Rehabilitation Versus Usual Treatment at Home in Patients With Early Stages of Alzheimer Disease.

INTRODUCTION

Assessing the benefit of cognitive rehabilitation (CR) remains difficult.

METHOD

An observational study was conducted in 33 patients with early-stage Alzheimer disease and their caregiver included in a clinical CR program at home, compared to 17 patients who received usual treatment. Evaluation of patient's dependence and objective and subjective caregiver's burden was performed by the caregiver with a research tool focusing on impairment in daily activities related to cognitive deficits.

RESULTS

Repeated measures analysis of variance showed a time by group interaction ( .05), with decreased patient's dependence for adapted activities at 1 year in the CR group. Lawton scale for daily activities showed also a time by group interaction ( < .05), with increased dependence at 1 year in the control group. There was a significant decrease in Mini-Mental State Examination scores in both groups at 1-year follow-up ( .05). Concerning caregiver's subjective burden, there was a trend for the time by group interaction ( = .07), and post hoc Tukey test showed that subjective burden was decreased in the CR group ( < .05). This was confirmed by nonparametric Mann-Whitney analysis on differences between follow-up and baseline evaluation ( < .05).

CONCLUSION

This observational study in a clinical setting is in line with the benefit of CR reported in recent randomized controlled trials. The benefit obtained for adapted daily activities remained after 1 year, even if global cognition declined. Moreover, caregiver's subjective burden related to all relevant daily activities evaluated within the CR program was decreased after 1 year in our clinical setting.