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Long-term observation of a multicomponent cognitive intervention in mild cognitive impairment.
J Clin Psychiatry 2012; 73(12):e1492-8JC

Abstract

BACKGROUND

Recent studies demonstrated benefits of cognitive intervention in mild cognitive impairment (MCI), but few studies have determined long-term effects on cognition, conversion rate to Alzheimer's disease, and the role of early intervention.

METHOD

A 6-month multicomponent cognitive group intervention was applied in participants with single- or multiple-domain amnestic MCI (defined according to Petersen's criteria). One group (n = 12) received the intervention at the beginning of the study period and was compared with an active control group (n = 12) who received it after an 8-month time lag. Follow-up assessments were conducted at 15 and 28 months (study period was August 2007-December 2009). The primary outcome was change in cognitive function as determined by changes in scores on the Mini-Mental State Examination and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), and the secondary outcomes were change in specific cognitive and noncognitive functions and conversion to Alzheimer's disease (according to DSM-IV/NINCDS-ADRDA criteria and NAI-AA criteria for probable Alzheimer's dementia with increased level of certainty).

RESULTS

Eighteen participants completed the study after 28 months. Long-term data revealed a stable intervention effect on the primary outcome ADAS-cog in the early-intervention group (P = .024). The participants in the later-intervention (control) group appeared to benefit to a lesser extent from the cognitive intervention compared to those who received it earlier. Only participants in the later-intervention group (6 of 12) converted to Alzheimer's disease during the 28-month study period.

CONCLUSIONS

Benefits of our 6-month cognitive intervention on global cognitive status appear to be preserved over extended follow-up periods. Early cognitive intervention may delay conversion to Alzheimer's disease. Findings in a small sample encourage the use of the intervention in larger-scale studies.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT00544856.

Authors+Show Affiliations

Department of Neuropsychology, Inn-Salzach Klinikum Psychiatric Hospital, Wasserburg/Inn, Germany. verena.buschert@iskl.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23290333

Citation

Buschert, Verena C., et al. "Long-term Observation of a Multicomponent Cognitive Intervention in Mild Cognitive Impairment." The Journal of Clinical Psychiatry, vol. 73, no. 12, 2012, pp. e1492-8.
Buschert VC, Giegling I, Teipel SJ, et al. Long-term observation of a multicomponent cognitive intervention in mild cognitive impairment. J Clin Psychiatry. 2012;73(12):e1492-8.
Buschert, V. C., Giegling, I., Teipel, S. J., Jolk, S., Hampel, H., Rujescu, D., & Buerger, K. (2012). Long-term observation of a multicomponent cognitive intervention in mild cognitive impairment. The Journal of Clinical Psychiatry, 73(12), pp. e1492-8. doi:10.4088/JCP.11m07270.
Buschert VC, et al. Long-term Observation of a Multicomponent Cognitive Intervention in Mild Cognitive Impairment. J Clin Psychiatry. 2012;73(12):e1492-8. PubMed PMID: 23290333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term observation of a multicomponent cognitive intervention in mild cognitive impairment. AU - Buschert,Verena C, AU - Giegling,Ina, AU - Teipel,Stefan J, AU - Jolk,Sabrina, AU - Hampel,Harald, AU - Rujescu,Dan, AU - Buerger,Katharina, PY - 2011/07/15/received PY - 2012/10/02/accepted PY - 2013/1/8/entrez PY - 2013/1/8/pubmed PY - 2013/2/21/medline SP - e1492 EP - 8 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 73 IS - 12 N2 - BACKGROUND: Recent studies demonstrated benefits of cognitive intervention in mild cognitive impairment (MCI), but few studies have determined long-term effects on cognition, conversion rate to Alzheimer's disease, and the role of early intervention. METHOD: A 6-month multicomponent cognitive group intervention was applied in participants with single- or multiple-domain amnestic MCI (defined according to Petersen's criteria). One group (n = 12) received the intervention at the beginning of the study period and was compared with an active control group (n = 12) who received it after an 8-month time lag. Follow-up assessments were conducted at 15 and 28 months (study period was August 2007-December 2009). The primary outcome was change in cognitive function as determined by changes in scores on the Mini-Mental State Examination and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), and the secondary outcomes were change in specific cognitive and noncognitive functions and conversion to Alzheimer's disease (according to DSM-IV/NINCDS-ADRDA criteria and NAI-AA criteria for probable Alzheimer's dementia with increased level of certainty). RESULTS: Eighteen participants completed the study after 28 months. Long-term data revealed a stable intervention effect on the primary outcome ADAS-cog in the early-intervention group (P = .024). The participants in the later-intervention (control) group appeared to benefit to a lesser extent from the cognitive intervention compared to those who received it earlier. Only participants in the later-intervention group (6 of 12) converted to Alzheimer's disease during the 28-month study period. CONCLUSIONS: Benefits of our 6-month cognitive intervention on global cognitive status appear to be preserved over extended follow-up periods. Early cognitive intervention may delay conversion to Alzheimer's disease. Findings in a small sample encourage the use of the intervention in larger-scale studies. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00544856. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/23290333/Long_term_observation_of_a_multicomponent_cognitive_intervention_in_mild_cognitive_impairment_ L2 - http://www.psychiatrist.com/jcp/article/pages/2012/v73n12/v73n1204.aspx DB - PRIME DP - Unbound Medicine ER -