Improvement of episodic memory in persons with mild cognitive impairment and healthy older adults: evidence from a cognitive intervention program
Belleville S, Gilbert B, Fontaine F, Gagnon L, Menard E, Gauthier S;
Commented by , 24 Nov 2006
Aim of the study
Establish the feasability of a cognitive intervention program in normal older persons (controls) and persons with Mild Cognitive Impairment (MCI) of the amnestic single or multiple domain type.
Method
French-speaking 20 MCI and 9 controls received the intervention and were compared to 8 MCI and 8 controls not receiving the intervention (waiting list group). The intervention focused on teaching episodic memory strategies: 8 weekly sessions lasting 120 minutes, using groups of 4-5 participants with one of three instructors who were experienced clinical neuropsychologists.
Computer-assisted attentional training preceded teaching of different methods to improve memory performance. The primary outcomes measures were three tasks of episodic memory: list recall, face-name association, text memory. Additional measures included a subjective memory and a well-being questionnaire, a measure of attentional control, and a verbal fluency test. Results were analyzed using analysis of variance.
Results
The intervention effect was significant on the delayed list recall (p<0.01 intervention effect) and face-name association (immediate: p<0.001 group effect, delayed: p<0.001 intervention and group effect). A significant effect was also found on measures of subjective memory and well-being. No changes were found in the waiting list group.
Professor Gauthier's comments
These results suggest that persons with MCI can improve their performance on episodic memory when provided with a structured cognitive training. These results must be confirmed in a prospective randomized study, where generalization and long-term benefit could be determined, with attention to high order leisure & hobbies as well as instrumental activities of daily living activities.
This study is somewhat of a relief considering the failure of well designed randomized clinical trials to show benefit in MCI with cholinesterase inhibitors and other drugs (ref. 1). A non-pharmacologic option is thus now available for persons with amnestic MCI.
This study and others to follow will be useful in updates of the Cochrane review on cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia, last published by Clare et al in The Cochrane Database of Systematic Reviews (ref. 2).
References
1. Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, et al. Mild cognitive impairment. Lancet 2006; 367 (9518); 1262-1270
2. Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A. Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database of Systematic Reviews 2006 Issue 4