"Keep up the good work"! A case study of the effects of a specific cognitive training in Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative condition characterized by significant impairment in multiple cognitive domains. In recent years, the development of cognitive trainings in AD has received significant attention. In the present case study we designed a cognitive training program (GEO, Geographical Exercises for cognitive Optimization) based on an errorless paradigm and tailored to the patient's cultural interests. The aim of this training was to investigate the potential for acquiring and possibly retaining both procedural and verbal knowledge in early-stage AD. This study involved an 80-year-old female patient diagnosed with early-stage AD, and 10 matched healthy subjects. Participants were asked to perform the two GEO training tasks: a "puzzle-like" task for procedural memory, and an "association" task for verbal memory. Both the patient and the healthy controls were subsequently trained with GEO using the same two tasks for 2 months. Although the patient's performance before training in both tasks was poor compared to healthy controls, after the training these differences disappeared. Our results showed that the patient was able to acquire new procedural abilities and verbal knowledge, and that her achievements were stable at the follow-up testing scheduled 3 months after the end of the intervention. This case study suggests a potentially useful strategy for cognitive training in AD.

Long-Lasting Neuropsychological Effects of a Computerized Cognitive Training in Patients Affected by Early Stage Alzheimer's Disease: Are They Stable Over Time?

INTRODUCTION: We investigated the stability of effects of a computerized cognitive training previously administered to a large group of early stage Alzheimer's disease (AD) patients, as compared with a control group. METHOD: Eighty AD patients were randomized in two groups and underwent a computerized cognitive training, or a control intervention. RESULTS: A Repeated Measures General Linear Model (RM-GLM) showed a significant interaction effect for the following neuropsychological tests: the digit span forward and backward, and the two-syllable words test, as measures of short-term memory and working memory; the Rivermead Behavioural Memory Test (RBMT) story immediate and the RBMT story delayed, as measures of ecologically oriented memory; the Token test, as measure of language comprehension; and the Brixton test, as an executive functions measure. CONCLUSION: Patients in the experimental group showed a significant improvement in various neuropsychological domains due to the training, and these effects decreased after 12 months.

A Case Study of the Long-Lasting Effects of Cognitive Training on Similar Tasks in Alzheimer's Disease.

OBJECTIVE: Cognitive training allows patients with Alzheimer's disease (AD) to reinforce their cognitive abilities. Here, we investigated the generalizability of trained skills to novel tasks, and their stability over time. METHOD: One patient underwent a structured cognitive training using the GEO (Geographical Exercise for cognitive Optimization) task, whereas 10 patients underwent a control intervention. Participants' performances on the GEO task, on a similar untrained task, and on a different untrained task were recorded before and after the intervention, and at the 24-month follow-up. RESULTS: On both the trained and the similar untrained tasks, patient's and controls' performance significantly differed from one another, with trained patient showing a significant acquirement of procedural skills that were maintained over time. CONCLUSION: Our preliminary evidence showed that a cognitive training could allow patients to acquire and maintain new skills not only on performing a trained task but surprisingly also on a similar untrained task.

Similarity among tasks is the key to show generalization of cognitive training effects in Alzheimer's disease: a case study.

Cognitive training can allow patients with Alzheimer's disease (AD) to reinforce individual cognitive abilities. In the present case study, we investigated the generalizability of trained cognitive skills to novel tasks, and their stability over time. One AD patient underwent a structured cognitive training using the GEO (Geographical Exercise for cognitive Optimization) task, whereas eight AD patients underwent a control cognitive intervention. Participants' performances on the GEO task, on a similar untrained cognitive task, and on a different untrained cognitive task were recorded before and after the intervention, and at the follow-up. On both the trained and the similar untrained tasks patients' and controls' performance significantly differed from one another. Our preliminary evidence shows that a cognitive training could allow patients to improve and maintain their performance not only on the trained task, but also on a similar task.

Computerized Structured Cognitive Training in Patients Affected by Early-Stage Alzheimer's Disease is Feasible and Effective: A Randomized Controlled Study.

INTRODUCTION: Alzheimer's disease (AD) presents with significant neuropsychological deficits. Cognitive training in AD has recently started to demonstrate its efficacy. In this study, we implemented computerized cognitive training of a large group of early-stage AD patients, to identify its effects at a neuropsychological level and to investigate whether they were stable after 6 months. METHOD: Overall, 80 AD patients were randomized in two groups. Patients in the experimental group used a structured rehabilitative software three times a week for 12 consecutive weeks aimed at training memory, attention, executive function and language skills, whereas patients in the control group underwent a control intervention. RESULTS: A Repeated Measures General Linear Model considering groups' performance at the three assessment points (before training, after training and at the 6-month follow-up) showed a significant interaction effect for: digit span forward (F(2,74) = 2.785, p = 0.03) and backward (F(2,74) = 3.183, p = 0.02), two-syllable words test (F(2,74) = 3.491, p = 0.004), Rivermead Behavioural Memory Test immediate (F(2,74) = 2.877, p = 0.03) and delayed (F(2,74) = 3.783, p = 0.003), Token test (F(2,74) = 4.783, p = 0.001), and Brixton test (F(2,74) = 8.783, p < 0.001). For all of them, experimental group performed better than controls. CONCLUSIONS: Patients in the experimental group showed a significant improvement in various neuropsychological domains, and their achievements were stable after 6 months. This study suggests an useful computerized training in AD, and should prompt further investigations about the generalizability of patients' acquired skills to more ecologically oriented tasks.