The effects of a comprehensive rehabilitation program of Alzheimer's Disease in a hospital setting.

ABSTRACT

INTRODUCTION: The evidence for the clinical effectiveness of cognitive rehabilitation in patients with Alzheimer's Disease (AD) is debated. Therefore it is important to collect more evidence about the outcome of non-pharmacological therapy of dementia. MATERIAL AND METHODS: We report data concerning the rehabilitation of 50 patients with probable AD admitted during a 17-month period in a specialized unit. Participants were affected by dementia ranging from mild to severe. The patients were treated with the Reality Orientation Therapy (ROT), integrated, when needed, with individualised cognitive approaches. The results concern the cognitive status, evaluated by means of the Mini Mental State Examination (MMSE), the functional status, evaluated with the Activity of Daily Living (ADL) scale, the assessment of psychological and behavioural disorders measured with the Neuropsychiatry Inventory (NPI). The cognitive, functional, and psychopathological assessments were administered at admission and discharge. RESULTS: The mean MMSE scores at admission and discharge were respectively 16.06 and 17.54 (Wilcoxon Ranks Test p=0.005). Mean ADL scores were 4.86 at admission and 5.02 at discharge (p=0.011). Mean NPI scores were respectively 21.46 and 12.26 (p<0.001). CONCLUSIONS: This survey of the 17-month experience suggests that a comprehensive treatment program may have beneficial effects on cognitive, functional, and in particular neuropsychiatric outcomes. The results should be verified with a randomised clinical trial.