Learning Objective #1: Identify the benefits and expected outcomes of cognitive stimulation exercises in the older population

Learning Objective #2: Identify the elements of a cognitive remediation program designed for the elder population

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Individuals with early stage dementia and those living with them cite memory deficits as their most disturbing problem but have few treatment options for this symptom. Symptoms of depression commonly occur in the early stages and increase the perceived rather than actual cognitive loss. As the disease process continues the focus often becomes more on disability rather than capability. An experimental design was used to test the assumption that consistent participation in a specific set of cognitive stimulating activities is associated with improved or sustained cognitive abilities and less depressive symptomology. From a population of 324 individuals over the age of 65, a sample of 31 subjects participated in the study. These subjects were randomized into a control group and a treatment group. In both groups were individuals with no cognitive impairment, mild impairment, and severe impairment. Repeated measures of mental status, dementia ratings, processing abilities, memory, and depression were completed on the control and treatment groups pre-intervention, immediately post intervention and eight weeks later. The intervention was provided on two consecutive days each week for six weeks. Each subject participated in three 20-minute sessions each day. One session consisted of concentration and attention exercises focused on skills such as word identification, visual recognition, categorization of stimuli into functional classes, symbolic representation, and task sequencing. Session two involved the use of computers and software specifically designed to enhance brain functions associated with attending to stimuli, conceptual skills, reasoning, decision making, processing speed, visual-spatial skills, and memory. Session three focused on the translation of abstract stimulation into more practical problem solving, independent thinking, and functional living skills. At six weeks 76% of participants demonstrated gains in some aspect of cognitive ability. Less depressive symptomology was present. Conclusions regarding ability to sustain these gains will be available in January 2005.

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