Cognitive Rehabilitation and Cognitive Function Among Mild Cognitive Impairment Community-Dwelling Elderly Adults: The Transtheoretical Model

Background: Mild cognitive impairment is a common clinical syndrome that identifies people at high risk of developing dementia, and the prevalence range from 7.7 to 51.7%. Although treatments for mild cognitive impairment are currently unavailable, preliminary evidence has identified potential neuro-protective effects of cognitive rehabilitation, which may lead to improved outcomes. However, the design and delivery of an appropriate programme for people with mild cognitive impairment is challenging for having physical, psychological, cognitive, and social barriers.

Purpose: The purposes of this study are to develop and examine cognitive rehabilitation program, on primary outcomes (cognitive function), and secondary outcomes (depression, quality of life and, Self-efficacy) among community-dwelling elderly adults with mild cognitive impairment.

Methods: We developed a cognitive rehabilitation base on the literature and our previous findings, then, 64 elderly adults with mild cognitive impairment were recruited in to a 2-group pretest-posttest randomized controlled trial for 12-week and a 12-week follow-up to examine its effectiveness. The χ² and t test used to test for differences between two groups; to address the effect of the intervention, the data were analyzed using a mixed model (intend to treat).

Results: After this 12-week cognitive rehabilitation program, the cognitive rehabilitation group participants showed significantly better Mini-Mental Status Examination (t=5.722, p=.000) and Alzheimer's Questionnaire (t=-5.088, p=.000) than those in the comparison group. Mixed model analysis showed the score of MMSE (interaction effect, F = 37.410, p<.001) and Alzheimer's Questionnaire (interaction effect, F = 41.785, p<.001) in participants of cognitive rehabilitation group is better than those in comparison group over time.

Conclusion: This is the first trial to exam the impact of cognitive rehabilitation interventions in mild cognitive impairment community-dwelling elderly in Taiwan. We found that the 12-week cognitive rehabilitation intervention could improve the cognitive function, quality of life and self-efficacy and decrease depressive symptoms among the participants. However, there is no impact on their physical function.