Authors (including presenting author) :
Lai YY(1)(2), Wong YK (1)(2), Mok CM(1)
Affiliation :
(1) Occupational Therapy Department, Castle Peak Hospital
(2) Department of Old Age Psychiatry, Castle Peak Hospital
Introduction :
Lifestyle factors, including cardiovascular risk factor, physical activity, diet, cognitive activity, social activity and stress, are found to be associated with cognitive function in old age. Many studies had supported that prevalence of neurocognitive disorder in the at-risk elderly can be modulated by modifying these lifestyle factors as early as possible. However, there is limited study on the use of lifestyle intervention on the elderly who have already suffered from the disease. A pioneer 8-session lifestyle intervention programme was developed for people with mild cognitive impairment and mild dementia to enhance their metacognition, facilitate and empower the incorporation of healthy lifestyle in their daily routine. Besides, individual cognitive training and the use of compensatory techniques were included in the programme to promote the training effectiveness.
Objectives :
To investigate the efficacy of lifestyle intervention with computer-assisted cognitive training for people with neurocognitive disorder
Methodology :
80 subjects were recruited from Memory Clinic and Specialist Out-patient Department of Department of Old Age Psychiatry in a psychiatric hospital, and then randomized to the experimental group (n=40) and the wait-list control group (n=40) by an investigator (blinded). Those in experimental group received 8 weekly sessions which consisted of 45-minute lifestyle intervention group training and 45-minute computer-assisted cognitive training. Outcome measures, included Mattis Dementia Rating Scale (Mattis DRS), Chinese version of Disability Assessment for Dementia (CDAD), WHO (Five) Well-Being Index (WHO-5) and Rosenberg Self-Esteem Scale (RSE), were conducted before (T0), immediately after (T1) and 6 weeks after (T2) the training programme.
Result & Outcome :
The results showed significant improvement in the adjusted total score of Mattis DRS (p = 0.03) and increasing trend of total score of CDAD (p > 0.05), though not statistically significant, in experimental group at T1. Meanwhile the waitlist-control group showed no significant change between T0 and T1 in these two outcome measures. For the sustainability effect, there was no significant difference in the adjusted total score of Mattis DRS (p > 0.05) of experimental group between T1 and T2. However, their total score of CDAD showed significant decline (p < 0.05) at T2. Besides, the total score of WHO-5 showed significant increase (p<0.05) in experimental group at T1 while RSE did not show significant change across all periods. The findings suggested that lifestyle intervention with computer-assisted cognitive training yields clinical benefits to the people with neurocognitive disorder, particularly for the improvement of cognitive function and well-being as well as the maintenance of functional performance. The gains in cognitive function can even be sustained after the training.
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