Comparison of the Effectiveness of a 12 Session with 24 Session Cognitive Rehabilitation Program for Patients with Dementia.

Abstract Description

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Authors (including presenting author) :

Leung SN(1), Ng YC(1), Lee WS(1), Kan SY(1)

Affiliation :

(1)Department of Occupational Therapy, Pamela Youde Nethersole Eastern Hospital

Introduction :

Effectiveness of cognitive rehabilitation program was well supported by literatures. However, no consensus was found on the optimal dosage of the cognitive rehabilitation program especially for patient with dementia and Instrumental Activities of Daily Living(IADL) problems.

Objectives :

To compare the effectiveness of a 12 session with 24 session Occupational Therapy cognitive rehabilitation program on cognitive and activity of daily living function for patients with dementia.

Methodology :

Patients with dementia, Montreal Cognitive Assessment Hong Kong Version(HK-MoCA) score ≤2nd percentile, referred for cognitive rehabilitation were recruited for a 24 session cognitive rehabilitation program. Assessments were conducted at recruitment, post 12 session and post 24 session training. Assessment tools are HK-MoCA, Modified BartheI Index(MBI), Lawton IADL-27 , Digit span test and Mattis Chinese Dementia Rating Scale(CDRS). Program content included tailored-made Virtual Reality IADL tasks, cognitive training software, self-care activity, home living skills training, physical training and home program.

Result & Outcome :

From January 2016 to January 2018, total 30 patients completed the dementia program. There were 10 males and 20 females, with mean age 76.7. Significant improvement were found in HK-MoCA in both post 12 and post 24 session program with improved mean score 2.1(p=0.00) and 2.2(p=0.00) respectively. More significant improvement was found in CDRS(total) in post 24 session than post 12 session program with improved mean score 5.8(p=0.04) and 2.8(p=0.00) respectively. In CDRS, significant improvement were found in initiation / preservation, attention and construct domains at post 24 session program. More significant improvement was found in Lawton IADL-27 in post 24 session than post 12 session program with improved mean score 2.8(p=0.00) and 0.8(p=0.06) respectively. The mean score difference between post 12 and 24 session was +2 and such finding was statistically significant(p=0.05). No significant change in MBI, digit span test scores could be found. The insignificant change of MBI score may be contributed by ceiling effect(recruitment mean score 93.8). CONCLUSION More significant improvement was not only found in cognitive aspects of 24 session program, but also with significant improvement in IADL functioning. 24 session program should be especially provided for patients with active role and need on IADL aspects while 12 session program could be provided for aim of enhancing general cognitive function.