Comparing two programs of cognitive training in Alzheimer's disease: a pilot study

Objectives - To evaluate the efficacy of two different procedures of individual cognitive training in mild to moderate Alzheimer's Disease (AD). Material and methods - Twenty-two AD patients entered the study. We compared stimulation of procedural memory (group 1) with training of partially spared cognitive functions (group 2). Assessment included: neuropsychological tests, scales, and the Functional Living Skills Assessment (FLSA), a standardized battery built to directly evaluate patients' performance in everyday life. Results - We observed a significant improvement for both groups after training in FLSA total score (P = 0.005) and subscales. For group 1. we also found a slightly improved performance in two tests: Attentional Matrices (P = 0.041). and Verbal Fluency for Letters (P = 0.059). After 3 months, patients' results showed a tendency to regress to the pro-training level. Conclusion - Both AD groups showed a substantial improvement after training in a direct performance measure of everyday functioning. However, results at neuro psycho logical tests suggest that training activities of daily living (supported by procedural memory) may be more effective than stimulating 'residual' cognitive functions.