Effects of combined training on neuropsychiatric symptoms and quality of life in patients with cognitive decline.
Mild cognitive impairment
Neuropsychiatric symptoms
Non-pharmacological interventions
Physical and cognitive training
Quality of life
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
28
05
2019
accepted:
17
07
2019
pubmed:
7
8
2019
medline:
1
5
2021
entrez:
7
8
2019
Statut:
ppublish
Résumé
Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI. Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7 months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer's Disease (QOL-AD) scale. After 7 months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL. Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can 'live well' with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Cognitive impairments associated with aging and dementia are major sources of neuropsychiatric symptoms (NPs) and deterioration in quality of life (QoL). Preventive measures to both reduce disease and improve QoL in those affected are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, NPs and QoL outcomes are too commonly overlooked in intervention trials. The purpose of this study was to test the effects of physical and cognitive training on NPs and QoL in MCI.
METHODS
METHODS
Baseline data from an MCI court (N = 93, mean age 74.9 ± 4.7) enrolled in the Train the Brain (TtB) study were collected. Subjects were randomized in two groups: a group participated to a cognitive and physical training program, while the other sticked to usual standard care. Both groups underwent a follow-up re-evaluation after 7 months from baseline. NPs were assessed using the Neuropsychiatric Inventory (NPI) and QoL was assessed using Quality of Life-Alzheimer's Disease (QOL-AD) scale.
RESULTS
RESULTS
After 7 months of training, training group exhibited a significant reduction of NPs and a significant increase in QOL-AD with respect to no-training group (p = 0.0155, p = 0.0013, respectively). Our preliminary results suggest that a combined training can reduce NPs and improve QoL.
CONCLUSIONS
CONCLUSIONS
Measuring QoL outcomes is a potentially important factor in ensuring that a person with cognitive deficits can 'live well' with pathology. Future data from non-pharmacological interventions, with a larger sample and a longer follow-up period, could confirm the results and the possible implications for such prevention strategies for early cognitive decline.
Identifiants
pubmed: 31385203
doi: 10.1007/s40520-019-01280-w
pii: 10.1007/s40520-019-01280-w
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1249-1257Subventions
Organisme : Fondazione Pisa
ID : Train the Brain
Investigateurs
L Maffei
(L)
E Picano
(E)
M G Andreassi
(MG)
A Angelucci
(A)
F Baldacci
(F)
L Baroncelli
(L)
T Begenisic
(T)
P F Bellinvia
(PF)
N Berardi
(N)
L Biagi
(L)
J Bonaccorsi
(J)
E Bonanni
(E)
U Bonuccelli
(U)
A Borghini
(A)
C Braschi
(C)
M Broccardi
(M)
R M Bruno
(RM)
M Caleo
(M)
C Carlesi
(C)
L Carnicelli
(L)
G Cartoni
(G)
L Cecchetti
(L)
M C Cenni
(MC)
R Ceravolo
(R)
L Chico
(L)
S Cintoli
(S)
G Cioni
(G)
M Coscia
(M)
M Costa
(M)
G D'Angelo
(G)
P D'Ascanio
(P)
M De Nes
(M)
S Del Turco
(S)
E Di Coscio
(E)
M Di Galante
(M)
N di Lascio
(N)
F Faita
(F)
I Falorni
(I)
U Faraguna
(U)
A Fenu
(A)
L Fortunato
(L)
R Franco
(R)
L Gargani
(L)
R Gargiulo
(R)
L Ghiadoni
(L)
F S Giorgi
(FS)
R Iannarella
(R)
C Iofrida
(C)
C Kusmic
(C)
F Limongi
(F)
M Maestri
(M)
M Maffei
(M)
S Maggi
(S)
M Mainardi
(M)
L Mammana
(L)
A Marabotti
(A)
V Mariotti
(V)
E Melissari
(E)
A Mercuri
(A)
S Micera
(S)
S Molinaro
(S)
R Narducci
(R)
T Navarra
(T)
M Noale
(M)
C Pagni
(C)
S Palumbo
(S)
R Pasquariello
(R)
S Pellegrini
(S)
P Pietrini
(P)
T Pizzorusso
(T)
A Poli
(A)
L Pratali
(L)
A Retico
(A)
E Ricciardi
(E)
G Rota
(G)
A Sale
(A)
S Sbrana
(S)
G Scabia
(G)
M Scali
(M)
D Scelfo
(D)
R Sicari
(R)
G Siciliano
(G)
F Stea
(F)
S Taddei
(S)
G Tognoni
(G)
A Tonacci
(A)
M Tosetti
(M)
S Turchi
(S)
L Volpi
(L)
Références
Mariani E, Monastero R, Mecocci P (2007) Mild cognitive impairment: a systematic review. J Alzheimers Dis 12:23–35. https://doi.org/10.3233/JAD-2007-12104
doi: 10.3233/JAD-2007-12104
pubmed: 17851192
Petersen RC, Smith GE, Waring SC et al (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56:303–308. https://doi.org/10.1001/archneur.56.3.303
doi: 10.1001/archneur.56.3.303
pubmed: 10190820
Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256:183–194. https://doi.org/10.1111/j.1365-2796.2004.01388
doi: 10.1111/j.1365-2796.2004.01388
pubmed: 15324362
Albert MS, DeKosky ST, Dickson D et al (2011) The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:270–279. https://doi.org/10.1016/j.jalz.2011.03.008
doi: 10.1016/j.jalz.2011.03.008
pubmed: 21514249
pmcid: 3312027
Palmer K, Backman L, Winblad B et al (2008) Mild cognitive impairment in the general population: occurrence and progression to Alzheimer disease. Am J Geriatr Psychiatry 16:603–611. https://doi.org/10.1097/JGP.0b013e3181753a64
doi: 10.1097/JGP.0b013e3181753a64
pubmed: 18591580
Sperling R, Johnson K (2013) Biomarkers of Alzheimer disease: current and future applications to diagnostic criteria. Continuum (Minneap Minn) 19:325–338. https://doi.org/10.1212/01.CON.0000429181.60095.99
doi: 10.1212/01.CON.0000429181.60095.99
Sperling R, Mormino E, Johnson K (2014) Evolution of preclinical Alzheimer’s disease: implications for prevention trials. Neuron 84:608–622. https://doi.org/10.1016/j.neuron.2014.10.038
doi: 10.1016/j.neuron.2014.10.038
pubmed: 25442939
pmcid: 4285623
Bruscoli M, Lovestone S (2004) Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr 16:129–140. https://doi.org/10.1017/S1041610204000092
doi: 10.1017/S1041610204000092
pubmed: 15318760
Manly JJ, Tang MX, Schupf N et al (2008) Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol 63:494–506. https://doi.org/10.1002/ana.21326
doi: 10.1002/ana.21326
pubmed: 18300306
pmcid: 2375143
Koepsell TD, Monsell SE (2012) Reversion from mild cognitive impairment to normal or near-normal cognition: risk factors and prognosis. Neurology 79:1591–1598. https://doi.org/10.1212/WNL.0b013e31826e26b7
doi: 10.1212/WNL.0b013e31826e26b7
pubmed: 23019264
pmcid: 3475624
Apostolova LG, Cummings JL (2008) Neuropsychiatric manifestations in mild cognitive impairment: a systematic review of the literature. Dement Geriatr Cogn Disord 25:115–126. https://doi.org/10.1159/000112509
doi: 10.1159/000112509
pubmed: 18087152
Perneczky R, Pohl C, Sorg C et al (2006) Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. Int J Geriatr Psychiatry 21:158–162. https://doi.org/10.1002/gps.1444
doi: 10.1002/gps.1444
pubmed: 16416470
Jefferson AL, Byerly LK, Vanderhill S et al (2008) Characterization of activities of daily living in individuals with mild cognitive impairment. Am J Geriatr Psychiatry 16:375–383. https://doi.org/10.1097/JGP.0b013e318162f197
doi: 10.1097/JGP.0b013e318162f197
pubmed: 18332397
pmcid: 2682324
Teng E, Becker BW, Woo E et al (2010) Subtle deficits in instrumental activities of daily living in subtypes of mild cognitive impairment. Dement Geriatr Cogn Disord 30:189–197. https://doi.org/10.1159/000313540
doi: 10.1159/000313540
pubmed: 20798539
pmcid: 2948658
Monastero R, Mangialasche F, Camarda C et al (2009) A systematic review of neuropsychiatric symptoms in mild cognitive impairment. J Alzheimers Dis 18:11–30. https://doi.org/10.3233/JAD-2009-1120
doi: 10.3233/JAD-2009-1120
pubmed: 19542627
Winblad B, Palmer K, Kivipelto M et al (2004) Mild cognitive impairment—beyond controversies, towards a consensus: report of the International Working Group on mild cognitive impairment. J Intern Med 256:240–246. https://doi.org/10.1111/j.1365-2796.2004.01380
doi: 10.1111/j.1365-2796.2004.01380
pubmed: 15324367
Kameyama K, Tsutou A, Fujino H (2016) The relationship between health-related quality of life and higher-level functional capacity in elderly women with mild cognitive impairment. J Phys Ther Sci 28:1312–1317. https://doi.org/10.1589/jpts.28.1312
doi: 10.1589/jpts.28.1312
pubmed: 27190474
pmcid: 4868234
Teng E, Tassniyom K, Lu PH (2012) Reduced quality of life ratings in mild cognitive impairment: analyses of subject and informant responses. Am J Geriatr Psychiatry 20:1016–1025. https://doi.org/10.1097/JGP.0b013e31826ce640
doi: 10.1097/JGP.0b013e31826ce640
pubmed: 23018474
pmcid: 3513348
Scholzel-Dorenbos CJ, van der Steen MJ, Engels LK et al (2007) Assessment of quality of life as outcome in dementia and MCI intervention trials: a systematic review. Alzheimer Dis Assoc Disord 21:172–178. https://doi.org/10.1097/WAD.0b013e318047df4c
doi: 10.1097/WAD.0b013e318047df4c
pubmed: 17545745
St John P, Montgomery PR (2010) Cognitive impairment and life satisfaction in older adults. Int J Geriatr Psychiatry 25:814–821. https://doi.org/10.1002/gps.2422
doi: 10.1002/gps.2422
pubmed: 20623664
Bowling A, Rowe G, Adams S et al (2015) Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales. Aging Ment Health 19:13–31. https://doi.org/10.1080/13607863.2014.915923
doi: 10.1080/13607863.2014.915923
pubmed: 24881888
Moniz-Cook E, Vernooij-Dassen M, Woods R et al (2008) A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 12:14–29. https://doi.org/10.1080/13607860801919850
doi: 10.1080/13607860801919850
pubmed: 18297476
Logsdon RG, Gibbons LE, McCurry SM et al (1999) Quality of life in Alzheimer’s disease: patient and caregiver reports. J Ment Health Aging 5:21–32
Sale A, Berardi N, Maffei L (2014) Environment and brain plasticity: towards an endogenous pharmacotherapy. Physiol Rev 94:189–234. https://doi.org/10.1152/physrev.00036.2012
doi: 10.1152/physrev.00036.2012
pubmed: 24382886
Huckans M, Hutson L, Twamley E et al (2013) Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults: working toward a theoretical model and evidence-based interventions. Neuropsychol Rev 23:63–80. https://doi.org/10.1007/s11065-013-9230-9
doi: 10.1007/s11065-013-9230-9
pubmed: 23471631
pmcid: 3640648
Logsdon RG, Gibbons LE, McCurry SM et al (2002) Assessing quality of life in older adults with cognitive impairment. Psychosom Med 64:510–519. https://doi.org/10.1097/00006842-200205000-00016
doi: 10.1097/00006842-200205000-00016
pubmed: 12021425
Train the Brain Consortium (2017) Randomized trial on the effects of a combined physical/cognitive training in aged MCI subjects: the Train the Brain study. Sci Rep 7:39471. https://doi.org/10.1038/srep39471
doi: 10.1038/srep39471
Cummings JL, Mega M, Gray K et al (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314. https://doi.org/10.1212/WNL.44.12.2308
doi: 10.1212/WNL.44.12.2308
pubmed: 7991117
Gates NJ, Sachdev P (2014) Is cognitive training an effective treatment for preclinical and early Alzheimer’s disease? J Alzheimers Dis 42:S551–S559. https://doi.org/10.1007/s11065-017-9363-3
doi: 10.1007/s11065-017-9363-3
pubmed: 25171716
Morris SB (2008) Estimating effect sizes from pretest-posttest-control group designs. Organ Res Methods 11:365–386. https://doi.org/10.1177/1094428106291059
doi: 10.1177/1094428106291059
Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198. https://doi.org/10.1016/0022-3956(75)90026-6
doi: 10.1016/0022-3956(75)90026-6
pubmed: 1202204
Selbæk G, Engedal K (2012) Stability of the factor structure of the neuropsychiatric inventory in a 31-month follow-up study of a large sample of nursing-home patients with dementia. Int Psychogeriatr 24:62–73. https://doi.org/10.1017/S104161021100086X
doi: 10.1017/S104161021100086X
pubmed: 21682940
Apostolova LG, Di LJ, Duffy EL et al (2014) Risk factors for behavioral abnormalities in mild cognitive impairment and mild Alzheimer’s disease. Dement Geriatr Cogn Disord 37:315–326. https://doi.org/10.1159/000351009
doi: 10.1159/000351009
pubmed: 24481207
pmcid: 4057985
Donovan NJ, Amariglio RE, Zoller AS et al (2014) Subjective cognitive concerns and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease. Am J Geriatr Psychiatry 22:1642–1651. https://doi.org/10.1016/j.jagp.2014.02.007
doi: 10.1016/j.jagp.2014.02.007
pubmed: 24698445
pmcid: 4145054
Missotten P, Squelard G, Ylieff M et al (2008) Relationship between quality of life and cognitive decline in dementia. Dement Geriatr Cogn Disord 25:564–572. https://doi.org/10.1159/000137689
doi: 10.1159/000137689
pubmed: 18544978
Ryan KA, Weldon A, Persad C et al (2012) Neuropsychiatric symptoms and executive functioning in patients with mild cognitive impairment: relationship to caregiver burden. Dement Geriatr Cogn Disord 34:206–215. https://doi.org/10.1159/000339955
doi: 10.1159/000339955
pubmed: 23128102
pmcid: 3698846
Sheikh F, Ismail Z, Mortby ME et al (2017) Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its association with caregiver burden. Int Psychogeriatr 7:1–12. https://doi.org/10.1017/S104161021700151X
doi: 10.1017/S104161021700151X
Isik AT, Soysal P, Solmi M et al (2018) Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer’s disease: a narrative review. Int J Geriatr Psychiatry. https://doi.org/10.1002/gps.4965
doi: 10.1002/gps.4965
pubmed: 30198597
Buschert VC, Friese U, Teipel SJ et al (2011) Effects of a newly developed cognitive intervention in amnestic mild cognitive impairment and mild Alzheimer’s disease: a pilot study. J Alzheimers Dis 25:679–694. https://doi.org/10.3233/JAD-2011-100999
doi: 10.3233/JAD-2011-100999
pubmed: 21483095
Jean L, Bergeron ME, Thivierge S et al (2010) Cognitive intervention programs for individuals with mild cognitive impairment: systematic review of the literature. Am J Geriatr Psychiatry 18:281–296. https://doi.org/10.1097/JGP.0b013e3181c37ce9
doi: 10.1097/JGP.0b013e3181c37ce9
pubmed: 20220584
Young SN (2007) How to increase serotonin in the human brain without drugs. J Psychiatry Neurosci 32:394–399
pubmed: 18043762
pmcid: 2077351
Veronese N, Solmi M, Basso C et al (2018) Role of physical activity in ameliorating neuropsychiatric symptoms in Alzheimer disease: a narrative review. Int J Geriatr Psychiatry. https://doi.org/10.1002/gps.4962
doi: 10.1002/gps.4962
pubmed: 30198597
Brookmeyer R, Johnson E, Ziegler-Graham K et al (2007) Forecasting the global burden of Alzheimer’s disease. Alzheimers Dement 3:186–191. https://doi.org/10.1016/j.jalz.2007.04.381
doi: 10.1016/j.jalz.2007.04.381
pubmed: 19595937
Liu S, Jones RN, Glymour MM (2010) Implications of lifecourse epidemiology for research on determinants of adult disease. Public Health Rev 32:489–511. https://doi.org/10.1007/BF03391613
doi: 10.1007/BF03391613
pubmed: 24639598
pmcid: 3955391
Dyer SM, Harrison SL, Laver K et al (2018) An overview of systematic reviews of pharmacological and non-pharmacological interventions for the treatment of behavioral and psychological symptoms of dementia. Int Psychogeriatr 30:295–309. https://doi.org/10.1017/S1041610217002344
doi: 10.1017/S1041610217002344
pubmed: 29143695
Ngandu T, Lehtisalo J, Solomon A et al (2015) A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 385:2255–2263. https://doi.org/10.1016/S0140-6736(15)60461-5
doi: 10.1016/S0140-6736(15)60461-5
pubmed: 25771249