COGNITIVE REHABILITATION IN ALZHEIMER'S DISEASE

认知康复已被证明在治疗各种神经疾病方面有效，包括创伤性脑损伤和中风。直到最近，检验认知康复对阿尔茨海默病(AD)影响的数据有限。我们最近由美国国立卫生研究院资助的认知康复试点试验的结果表明，采用特定技术(如间隔提取、程序性学习和双重认知支持)的综合计划显著改善并保持了服用稳定剂量胆碱酯酶抑制剂的轻度受损AD患者在一些认知任务上的表现。鉴于未来有望出现更新、更有效的药理药物，这些发现对优化和维持患者的认知和 功能独立。这项拟议的研究试图比较接受胆碱酯酶抑制剂治疗的轻度受损AD患者与仅服用胆碱酯酶抑制剂的轻度受损AD患者进行前瞻性记忆训练的改进认知康复计划的疗效。这项研究的一个独特方面是确定维持治疗可以最大限度地延长干预后认知康复治疗成果的程度。除了对AD患者的直接好处外，还将评估干预措施对照顾者痛苦和感知负担的影响。

Cognitive rehabilitation has been shown to be effective in treating a wide variety of neurological disorders including traumatic brain injury and stroke. Until recently, there has been limited data examining the effects of cognitive rehabilitation in Alzheimer's Disease (AD). Results from our recent NIH-funded Cognitive Rehabilitation Pilot Trial demonstrate that an integrated program that employs specific techniques such as spaced retrieval, procedural learning and dual cognitive support significantly improves and maintains gains in performance on a number of cognitive tasks among mildly impaired AD patients who are on a stable dose of a cholinesterase inhibitor. Given the promise of newer and more effective pharmacological agents in the future, these findings have important implications for optimizing and maintaining the patient's cognitive and functional independence. The proposed study represents an attempt to compare the efficacy of an improved cognitive rehabilitation program incorporating prospective memory training among mildly impaired AD patients on a cholinesterase inhibitor versus mildly impaired patients on a cholinesterase inhibitor alone. A unique aspect of this study is to determine the extent to which maintenance sessions can maximally prolong postintervention cognitive rehabilitation treatment gains. In addition to the direct benefit to AD patients, the interventions will be evaluated with regards to their impact on caregiver's distress and perceived burden.