Cognitive stimulation program in mild cognitive impairment A randomized controlled trial.

Non-pharmacological cognitive interventions in mild cognitive impairment have demonstrated promising results in preventing or delaying cognitive impairment and functional disability. Cognitive stimulation seems to improve and maintain cognitive and social activity. OBJECTIVE: This study aimed to evaluate the impact of a cognitive stimulation program in mild cognitive impairment (MCI) at the cognitive level on activities of daily living (ADLs), and levels of anxiety and depression. METHODS: A randomized controlled single-blind trial involving 122 non-institutionalized elderly with a MEC-35 score of 24-27 was conducted. The intervention group (n=54) received the intervention (10-week cognitive stimulation program) and was compared with a control group (n=68) that received no intervention. Follow-up assessments were conducted post-test and at 6 months post-test. The primary outcome was cognitive function determined by changes in scores on the Spanish version (MEC-35) of the Mini-Mental State Examination, while the secondary outcomes were measured by the Barthel Index, Lawton and Brody Scale, Goldberg Questionnaire (anxiety sub-scale) and the Yesavage Geriatric Depression Scale (15-item version). RESULTS: The intervention group showed a significant improvement in cognitive function at both timepoints, post-test and 6-month follow-up. The Barthel Index was higher in the intervention group, but only on the post-test analysis. The intervention did not improve the performance of instrumental ADLs or depression or anxiety levels. CONCLUSION: The findings showed cognitive improvements in an elderly population with MCI in the short and medium-term and improved basic ADLs in the short term. Clinicaltrials.gov Identifier: NCT03831061.

As intervenções cognitivas não farmacológicas no comprometimento cognitivo leve demonstram resultados promissores na prevenção ou retardo no comprometimento cognitivo e na incapacidade funcional. A estimulação cognitiva parece melhorar e manter a atividade cognitiva e social. OBJETIVO: Nosso objetivo foi o de avaliar um programa de estimulação cognitiva sobre o comprometimento cognitivo leve no nível cognitivo, nas atividades da vida diária, níveis de ansiedade e depressão. MÉTODOS: Um estudo randomizado, controlado e cego, foi implementado em 122 idosos não institucionalizados com escore 24-27 na versão em espanhol do Mini Exame do Estado Mental (MEC-35). O grupo de intervenção (n=54) recebeu a intervenção (programa de estimulação cognitiva de 10 semanas) e foi comparado com um grupo de controle (n=68) que não recebeu nenhuma intervenção. Avaliações de acompanhamento foram realizadas pós-teste e 6 meses pós-teste. O desfecho primário foi a função cognitiva determinada pelas alterações nos escores do MEC-35 e os desfechos secundários foram medidos pelo Índice de Barthel, Escala de Lawton e Brody, Escala de Lawton e Brody, Questionário Goldberg (subescala de ansiedade) ) e a Escala de Depressão Geriátrica de Yesavage (versão de 15 itens). RESULTADOS: O grupo intervenção apresentou uma melhora significativa na função cognitiva nas duas medidas de tempo, pós-teste e 6 meses de acompanhamento. O Índice de Barthel foi encontrado mais alto no grupo de intervenção, mas apenas na análise pós-teste. A intervenção não melhorou o desempenho de atividades instrumentais da vida diária e níveis de depressão ou ansiedade. CONCLUSÃO: Os achados mostram melhorias cognitivas no comprometimento cognitivo leve da população idosa em curto e médio prazo e melhoraram as atividades básicas da vida diária em curto prazo. Identificador do Clinicaltrials.gov: NCT03831061.

Cognitive stimulation program in mild cognitive impairment A randomized controlled trial / Programa de estimulação cognitiva no comprometimento cognitivo leve: um estudo controlado randomizado

Abstract. Non-pharmacological cognitive interventions in mild cognitive impairment have demonstrated promising results in preventing or delaying cognitive impairment and functional disability. Cognitive stimulation seems to improve and maintain cognitive and social activity. Objective: This study aimed to evaluate the impact of a cognitive stimulation program in mild cognitive impairment (MCI) at the cognitive level on activities of daily living (ADLs), and levels of anxiety and depression. Methods: A randomized controlled single-blind trial involving 122 non-institutionalized elderly with a MEC-35 score of 24-27 was conducted. The intervention group (n=54) received the intervention (10-week cognitive stimulation program) and was compared with a control group (n=68) that received no intervention. Follow-up assessments were conducted post-test and at 6 months post-test. The primary outcome was cognitive function determined by changes in scores on the Spanish version (MEC-35) of the Mini-Mental State Examination, while the secondary outcomes were measured by the Barthel Index, Lawton and Brody Scale, Goldberg Questionnaire (anxiety sub-scale) and the Yesavage Geriatric Depression Scale (15-item version). Results: The intervention group showed a significant improvement in cognitive function at both timepoints, post-test and 6-month follow-up. The Barthel Index was higher in the intervention group, but only on the post-test analysis. The intervention did not improve the performance of instrumental ADLs or depression or anxiety levels. Conclusion: The findings showed cognitive improvements in an elderly population with MCI in the short and medium-term and improved basic ADLs in the short term. Clinicaltrials.gov Identifier: NCT03831061.

Resumo. As intervenções cognitivas não farmacológicas no comprometimento cognitivo leve demonstram resultados promissores na prevenção ou retardo no comprometimento cognitivo e na incapacidade funcional. A estimulação cognitiva parece melhorar e manter a atividade cognitiva e social. Objetivo: Nosso objetivo foi o de avaliar um programa de estimulação cognitiva sobre o comprometimento cognitivo leve no nível cognitivo, nas atividades da vida diária, níveis de ansiedade e depressão. Métodos: Um estudo randomizado, controlado e cego, foi implementado em 122 idosos não institucionalizados com escore 24-27 na versão em espanhol do Mini Exame do Estado Mental (MEC-35). O grupo de intervenção (n=54) recebeu a intervenção (programa de estimulação cognitiva de 10 semanas) e foi comparado com um grupo de controle (n=68) que não recebeu nenhuma intervenção. Avaliações de acompanhamento foram realizadas pós-teste e 6 meses pós-teste. O desfecho primário foi a função cognitiva determinada pelas alterações nos escores do MEC-35 e os desfechos secundários foram medidos pelo Índice de Barthel, Escala de Lawton e Brody, Escala de Lawton e Brody, Questionário Goldberg (subescala de ansiedade) ) e a Escala de Depressão Geriátrica de Yesavage (versão de 15 itens). Resultados: O grupo intervenção apresentou uma melhora significativa na função cognitiva nas duas medidas de tempo, pós-teste e 6 meses de acompanhamento. O Índice de Barthel foi encontrado mais alto no grupo de intervenção, mas apenas na análise pós-teste. A intervenção não melhorou o desempenho de atividades instrumentais da vida diária e níveis de depressão ou ansiedade. Conclusão: Os achados mostram melhorias cognitivas no comprometimento cognitivo leve da população idosa em curto e médio prazo e melhoraram as atividades básicas da vida diária em curto prazo. Identificador do Clinicaltrials.gov: NCT03831061.

Análisis del efecto de un programa de estimulación cognitiva en personas con envejecimiento normal en Atención Primaria: ensayo clínico aleatorizado / Analysis of the effect of a program of cognitive stimulation in elderly people with normal aging in primary care: Randomized clinical trial

Objetivo: Aportar evidencias de la eficacia de una intervención comunitaria en salud, que incluye un programa de estimulación cognitiva, para prevenir el deterioro de las capacidades cognitivas en nuestra población de personas mayores con cognición normal que viven en la comunidad. Diseño: Ensayo clínico aleatorizado (normas grupo CONSORT). Emplazamiento: Centro de salud San José Norte-Centro y Fundación La Caridad (Zaragoza). Participantes: Doscientas una personas de 65 años o más, con puntuación MEC de 28 puntos o más, 101 aleatorizados en el grupo intervención y 100 en el grupo control. Intervenciones: La intervención se realizó en 10 sesiones de 45 min, una por semana, con material propio, los cuadernos de colores de activación mental. Estos cuadernos trabajan las áreas de memoria, orientación, lenguaje, praxis, gnosis, cálculo, percepción, razonamiento lógico, atención-concentración y programación. Mediciones principales: Las variables de resultado fueron MEC, Set-test, Barthel y Lawton-Brody. Resultados: Analizando los incrementos sobre el nivel basal, para la variable MEC el grupo intervención obtiene, en media, 1,58 puntos más que el grupo control en la evaluación realizada inmediatamente después de la intervención. A los 6meses la mejora es de 1,51 puntos y al año de 2,04 puntos. Todos estos incrementos son estadísticamente significativos al nivel usual del 5%. No se observan diferencias estadísticamente significativas entre el grupo intervención y control en las variaciones sobre el nivel basal de las variables en Set-test, Barthel y Lawton-Brody. Conclusiones: La estimulación cognitiva con nuestro programa es eficaz para mantener el rendimiento cognitivo, medido con la variable MEC, en nuestra población de personas mayores con cognición normal que viven en la comunidad. No hay evidencia de que esa mejora se transfiera a las actividades de la vida diaria medidas con Barthel y Lawton-Brody

Objective: To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. Design: Randomized clinical trial (CONSORT group norms). Location: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). Participants: 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). Intervention: The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. Main measurements: The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. Results: Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. Conclusions; Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables

[Analysis of the effect of a program of cognitive stimulation in elderly people with normal aging in primary care: Randomized clinical trial]. / Análisis del efecto de un programa de estimulación cognitiva en personas con envejecimiento normal en Atención Primaria: ensayo clínico aleatorizado.

OBJECTIVE: To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. DESIGN: Randomized clinical trial (CONSORT group norms) LOCATION: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). PARTICIPANTS: 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). INTERVENTION: The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. MAIN MEASUREMENTS: The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. RESULTS: Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. CONCLUSIONS: Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables.