Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia
Open accessAbstract
BACKGROUND: Cognitive impairments, particularly memory problems, are a defining feature of the early stages of Alzheimer's disease (AD) and vascular dementia. Cognitive training and cognitive rehabilitation are specific interventional approaches designed to address difficulties with memory and other aspects of cognitive functioning. The present review is an update of previous versions of this review. OBJECTIVES: The main aim of the current review was to evaluate the effectiveness and impact of cognitive training and cognitive rehabilitation for people with mild Alzheimer's disease or vascular dementia in relation to important cognitive and non-cognitive outcomes for the person with dementia and the primary caregiver in the short, medium and long term. SEARCH METHODS: The CDCIG Specialized Register, ALOIS, which contains records from MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS and many other clinical trial databases and grey literature sources, was most recently searched on 2 November 2012. SELECTION CRITERIA: Randomised controlled trials (RCTs), published in English, comparing cognitive rehabilitation or cognitive training interventions with control conditions, and reporting relevant outcomes for the person with dementia and/or the family caregiver, were considered for inclusion. DATA COLLECTION AND ANALYSIS: Eleven RCTs reporting cognitive training interventions were included in the review. A large number of measures were used in the different studies, and meta-analysis could be conducted for 11 of the primary and secondary outcomes of interest. Several outcomes were not measured in any of the studies. The unit of analysis in the meta-analysis was the change from baseline score. Overall estimates of treatment effect were calculated using a fixed-effect model, and statistical heterogeneity was measured using a standard Chi(2) statistic. One RCT of cognitive rehabilitation was identified, allowing examination of effect sizes, but no meta-analysis could be conducted. MAIN RESULTS: Cognitive training was not associated with positive or negative effects in relation to any reported outcomes. The overall quality of the trials was low to moderate. The single RCT of cognitive rehabilitation found promising results in relation to a number of participant and caregiver outcomes, and was generally of high quality. AUTHORS' CONCLUSIONS: Available evidence regarding cognitive training remains limited, and the quality of the evidence needs to improve. However, there is still no indication of any significant benefit derived from cognitive training. Trial reports indicate that some gains resulting from intervention may not be captured adequately by available standardised outcome measures. The results of the single RCT of cognitive rehabilitation show promise but are preliminary in nature. Further, well-designed studies of cognitive training and cognitive rehabilitation are required to obtain more definitive evidence. Researchers should describe and classify their interventions appropriately using available terminology.
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Cognitive stimulation improves general cognitive functioning in patients with mild-to-moderate dementia.
“Several studies reported an improvement of general cognitive functioning in patients with mild-to-moderate dementia after CS sessions of variable length (69–74).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [72]
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- MED- LINE (1950-present); Journal Citation Re- ports] Topic=(dement* OR VCI OR "vascu- lar cognitive impairment*" OR VaD OR alzheimer*) AND Topic=("cognit* train*" OR "cognit* rehab*" OR "memory aid*" OR "memory train*" OR "memory sup- port*" OR "memory stimul*") AND Topic=(randomly OR placebo OR groups OR trial OR RCT OR randomized OR randomised) AND Year Published=(2009- 2011) Timespan=2009-2011.
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Cognitive training for people with mild to moderate dementia
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- Authors
- Bahar-Fuchs, A., Clare, L., & Woods, B.
- Affiliations
- Australian National University; Centre for Research on Ageing, Health, and Wellbeing; Building 63, Eggleston Rd., Acton Canberra ACT Australia 2600
- Bangor University (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2013-06-05
- Volume
- 2013
- Issue
- 6
- Pages
- CD003260-CD003260
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC7144738
- OpenAlex
- W1939289671
- Cited by
- 507
- References
- 163
- Citations by year
- 2026: 16 · 2025: 36 · 2024: 45 · 2023: 32 · 2022: 30 · 2021: 44 · 2020: 65 · 2019: 44 · 2018: 33 · 2017: 48 · 2016: 44 · 2015: 32 · 2014: 29 · 2013: 8 · 2012: 1
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- cognitive training, cognitive rehabilitation, Alzheimer's disease, vascular dementia, mild cognitive impairment, memory impairment, dementia caregivers, caregiver outcomes, treatment effectiveness, outcome measures, intervention classification, dementia interventions, non-cognitive outcomes, early-stage dementia, trial heterogeneity, primary and secondary outcomes, intervention intensity
- MeSH terms
- Alzheimer Disease, Humans, Dementia, Vascular, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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