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PubMed | Cognitive Impairment Center and Villa Santa Maria Institute
Type: Journal Article | Journal: Journal of Alzheimer's disease : JAD | Year: 2016

The pharmacological treatment of Alzheimers disease (AD) is based largely on cholinesterase inhibitors (ChEI).To investigate whether or not some non-pharmacological and contextual factors measured prior to starting treatment such as past occupation, lifestyles, marital status, degree of autonomy and cognitive impairment, living alone or with others, and the degree of brain atrophy are associated with a better response to ChEI treatment.Eighty-four AD and six AD with cerebrovascular disease (AD +CVD) outpatients of Treviso Dementia (TREDEM) Registry, with an average cholinesterase inhibitors treatment length of four years, were considered. The outpatients had undergone a complete evaluation and some non-pharmacological and contextual factors were collected. We defined responder a patient with a delta score T0 - T1 equal or inferior to 2.0 points per year of MMSE and a non-responder a patient with a delta score T0 - T1 superior to 2.0 points per year. In order to identify hidden relationships between variables related to response and non-response, we use a special kind of artificial neural network called Auto-CM, able to create a semantic connectivity map of the variables considered in the study.A higher cognitive profile, a previous intellectual occupation, healthier lifestyles, being married and not living alone, a higher degree of autonomy, and lower degree of brain atrophy at baseline resulted in affecting the response to long-term ChEI therapy.Non-pharmacological and contextual factors appear to influence the effectiveness of treatment with ChEI in the long term.

Spagnolo P.,Cognitive Impairment Center | Spagnolo P.,Local Health Authority | Arico M.,Cognitive Impairment Center | Arico M.,Local Health Authority | And 9 more authors.
NeuroRehabilitation | Year: 2015

OBJECTIVES: Cognitive Stimulation (CS) trainings are non-pharmacological treatments widely used in dementia care. 3R Mental Stimulation is a particular type of CS, which consists of sequential association of ROT, Reminiscence and Remotivation during the same session. This pilot study sought to investigate whether CS, based on 3R program, could benefit cognitive functions, autonomy and behavioral disorders. METHOD: 3R-CS treatment was applied to 36 patients, which are part of the 'TREDEM' study sample, and their caregivers. All patients received a multidimensional assessment consisting of a socio-demographic, clinical and neuropsychological data collection. RESULTS: After CS treatment a significant improvement was detected in cognition and autonomy in basic activities of daily living. Caregiver distress was decreased. Behavioral disturbances were reduced even when considering a potential confounding factor such as treatment with anticholinesterase or NMDA receptor antagonist drugs. CONCLUSION: The findings demonstrated that 3R-CS can benefit cognitive functions and level of autonomy in the basic activities of daily living and also it can reduce behavioral disorders and caregiver's distress. © 2015 - IOS Press and the authors. All rights reserved.

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