Cognitive stimulation is beneficial, even after diagnosis of Alzheimer’s

An inter­est­ing arti­cle in Nature Reviews last month reviewed sev­er­al stud­ies show­ing that cog­ni­tive inter­ven­tion can be ben­e­fi­cial even for indi­vid­u­als already diag­nosed with Alzheimer’s Dis­ease (Buschert et al., 2010).

The arti­cle shows that patients with mild-to-mod­er­ate demen­tia can ben­e­fit from a range of cog­ni­tive inter­ven­tions: from train­ing of par­tial­ly spared cog­ni­tive func­tions to train­ing on activ­i­ties of dai­ly liv­ing. Results sug­gest that such inter­ven­tions can improve glob­al cog­ni­tion, abil­i­ties of dai­ly liv­ing and qual­i­ty of life in these patients.

Patients with mod­er­ate-to-severe demen­tia seem to ben­e­fit from gen­er­al engage­ment in activ­i­ties that enhance cog­ni­tive and social func­tion­ing in a non-spe­cif­ic manner.

In gen­er­al, for patients diag­nosed with Alzheimer’s Dis­ease, the reviewed stud­ies sug­gest that pro­grams focus­ing on glob­al cog­ni­tive stim­u­la­tion are more effec­tive than pro­grams that train spe­cif­ic cog­ni­tive functions.

The oppo­site seems true for peo­ple diag­nosed with Mild Cog­ni­tive Impair­ment (MCI). As you may remem­ber, MCI diag­no­sis is made upon objec­tive mem­o­ry deficits that do not inter­fere with activ­i­ties of dai­ly liv­ing. 5 to 10% of peo­ple with MCI devel­op demen­tia with­in 1 year after being diagnosed.

It is inter­est­ing to see that the type of cog­ni­tive inter­ven­tion one may ben­e­fit from changes over the years, depend­ing on one’s cog­ni­tive sta­tus. This shows once again that there is no gen­er­al mag­ic pill in terms of brain fit­ness: Some inter­ven­tions or pro­grams work because they meet the needs of some spe­cif­ic indi­vid­u­als. No pro­gram can work for everybody.

Accord­ing to Buschert and col­leagues (2010) pro­grams focus­ing on glob­al cog­ni­tive stim­u­la­tion could delay the onset of Alzheimer’s Dis­ease “by 5 years in patients who will even­tu­al­ly devel­op this con­di­tion. As a result, the preva­lence of AD could decrease by 50%, lead­ing to sub­stan­tial per­son­al, social and eco­nom­ic benefits.”

The authors con­clude that efforts to devel­op and imple­ment cog­ni­tive-based inter­ven­tion for the treat­ment of Alzheimer’s Dis­ease must be pur­sued. Indeed, cog­ni­tive inter­ven­tions have sev­er­al advan­tages com­pared to phar­ma­co­log­i­cal treat­ments: a) low­er costs, b) no side effects, and c) high­er cost-effec­tive­ness (on aver­age, anti-demen­tia drugs delay cog­ni­tive decline by only 6–12 months).