Use of Physical and Intellectual Activities and Socialization in the Management of Cognitive Decline of Aging and in Dementia: A Review

Table 2

Summary of trials involving cognitive interventions in AD patients.

Study	Length and frequency	Type of stimulation	Sample	MMSE; (baseline mean)	Outcome measures	Major findings
Buschert et al. [59]	6 months; 2 hours 1x/wk	Multicomponent intervention with focus on CS	𝑛ex=8; 𝑛𝑐=7	Experimental: 24.5; Control: 25.3	(i) MMSE; (ii) ADAS-Cog; (iii) TMT; (iv) RBANS story memory and recall; (v) QoL-AD; (vi) MADRS	(i) No significant benefit
Chapman et al. [58]	8 wks; 90-minute sessions 1x/wk	Cognitive stimulation	𝑛ex=28; 𝑛𝑐=26	20.87	(i) MMSE; (ii) ADAS-Cog; (iii) TFLS; NPI-irritability and apathy; (iv) QoL-AD; (v) CBIC	(i) Modest positive effects on language, global and functional abilities, and emotional wellbeing in experimental group compared to control group just treated with donepezil
Spector et al. [57]	7 wks; 45-minute sessions 2x/wk	Cognitive stimulation	𝑛ex=97; 𝑛𝑐=70	Experimental: 14.2; Control: 14.8	(i) MMSE; (ii) ADAS-Cog; (iii) QoL-AD; (iv) HCS; (v) Cornell Scale for Depression in Dementia; (vi) CAPE-BRS; (vii) CDR	(i) Significant improvement on the MMSE, ADAS-COG, and QoL-AD
Onder et al. [60]	25 wks; 30-minute sessions 3x/wk	Reality orientation	𝑛ex=70; 𝑛𝑐=67	Experimental: 20.2; Control: 19.9	(i) MMSE; (ii) ADAS-Cog; (iii) Functional status: Barthel Index,; (iv) IADL; (v) NPI; (vi) Family caregiver outcomes: HRSD, HRSA, Caregiver Burden Inventory, SF-36	(i) Small improvement in MMSE and ADAS-COG
Loewenstein et al. [64]	12–16 weeks; 45-minute sessions 2x/wk	Cognitive rehabilitation/cognitive training	𝑛ex=25; 𝑛𝑐=19	Experimental: 23.40; Control: 24.53	(i) The face-name association task: (ii) Orientation; (iii) The continuous performance test; (iv) Procedural object-memory evaluation; (v) Modified Making-Change-For-A-Purchase Task; (vi) Balancing-A-Checkbook Task; (vii) RMBPC; (viii) B-ADLS; (ix) CES-D; (x) IQCODE	(i) Training specific improvement in orientation, face-name recall, processing speed, and making change compared to control group receiving mental stimulation
Davis et al. [65]	5 weeks; 1-hour sessions 1x/wk; home practice 30 minutes per day 6x/wk	Cognitive training	𝑛ex=19; 𝑛𝑐=18	Experimental: 21.84; Control: 22.78	(i) MMSE; (ii) WMS-R logical memory; (iii) WMS-R visual reproduction; (iv) WAIS-R digit span; (v) VSAT; (vi) Controlled oral word association test; (vii) Category fluency; (viii) Finger taping test; (ix) GDS; (x) Quality of life patient	(i) Improvement in attention, recall of personal information, and face-name recall compared to mock control group; (ii) Results did not extend to other neuropsychological tests or quality of life
Koltai et al. [67]	Group program: 5 wks; 1-hour sessions 1x/wk; Individual program: 6 wks; 1-hour sessions 1x/wk with caregiver involvement in last 10–15 minutes	Cognitive rehabilitation/cognitive training	𝑛ex=14; 𝑛𝑐=8	Experimental: 22.9; Control: 26.6	(i) GDS and relative GDS; (ii) EMQ and relative EMQ; (iii) CERAD; (iv) MMSE	(i) No significant differences between the experimental group and the wait-list control group; (ii) Participants with insight about self-deficits perceived greater gains in memory compared to participants with no insight
Quayhagen et al. [66]	8 weeks; 1-hour sessions 5x/wk	Cognitive training	𝑛AD=103; 𝑛𝑐=103; (i) Numbers in each group (cognitive training, dyadic counseling, dual supportive seminar, and early-stage day care) not specified	Not reported	(i) Immediate memory composite: WMS-R Logical Memory 1 and visual reproduction 1, DRS (memory); (ii) Delayed memory composite: WMS logical memory 2, visual reproduction 2; (iii) Verbal fluency composite: controlled oral word association, DRS (initiation); (iv) Problem solving composite: geriatric coping schedule, DRS (conceptualization); (v) Memory and Behavior Problems Checklist (part A)	(i) Improvement in memory and communication with caregiver; (ii) Other types of interventions (dual support seminar, early-stage daycare) had positive effects on communication and interactions
Cahn-Weiner et al. [71]	6 wks; 45-minute sessions 2x/wk	Memory training	𝑛ex=17; 𝑛𝑐=17	Experimental: 24.3; Control: 25.1	(i) HVLT-R; (ii) BVMT-R; (iii) BNT; (iv) COWA; (v) JLO; (vi) TMT (Parts A and B); (vii) ADL questionnaire; (viii) EMQ	(i) No significant effects

𝑛_ex,𝑛_𝑐,𝑛_AD: number of participants in intellectual stimulation program, control group, and group diagnosed with AD. MMSE: Mini-Mental state examination, ADAS-Cog: Alzheimer’s Disease Assessment Scale-Cognitive Subscale, TMT: Trail Making Test, RBANS: Repeatable Battery for the Assessment of Neuropsychological Status Versions A (before testing) and B (after testing), QoL-AD: quality of life-Alzheimer’s disease, MADRS: Montgomery-Asberg Depression Rating Scale, TFLS: Texas Functional Living Scale, NPI: Neuropsychiatric Inventory, CIBIC: Clinician’s Interview-Based Impression of Change, HCS: Holden Communication Scale, CAPE-BRS: The Clifton Assessment Procedures for the Elderly-Behaviour Rating Scale, CDR: The Clinical Dementia Rating Scale, IADL: instrumental activities of daily living, HRSD: Hamilton Rating Scales for Depression, HRSA: Hamilton Rating Scales for Anxiety, SF-36: The Medical Outcomes Study 36-Item Short-Form General Health Survey, RMBPC: The Revised Memory and Behavior Problems Checklist, B-ADLS: The Bayer Activities of Daily Living Scale, CES-D: The Center for Epidemiological Studies-Depression Scale, IQCODE: the informant questionnaire of the cognitive decline in the elderly scale, WMS-R: Wechsler Memory Scale-Revised, WAIS-R: Wechsler Adult Intelligence Scale-Revised, VSAT: The Verbal Series Attention Test, GDS: Geriatric Depression Scale, EMQ: Everyday Memory Questionnaire, CERAD: Consortium to Establish a Registry for Alzheimer’s Disease Test Battery, DRS: The Mattis Dementia Rating Scale, HVLT-R: Hopkins Verbal Learning Test Revised, BVMT-R: Brief Visual Spatial Memory Test Revised, BNT: Boston Naming Test, COWA: Controlled Oral Word Association Test, and JLO: Judgment of Line Orientation.