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Randomized Controlled Trial
. 2019 May 24;11(10):3138-3155.
doi: 10.18632/aging.101970.

Comparison between physical and cognitive treatment in patients with MCI and Alzheimer's disease

Cristina Fonte  1 , Nicola Smania  1   2 , Anna Pedrinolla  3 , Daniele Munari  1   2 , Marialuisa Gandolfi  1   2 , Alessandro Picelli  1   2 , Valentina Varalta  1 , Maria V Benetti  3 , Annalisa Brugnera  3 , Angela Federico  3 , Ettore Muti  4 , Stefano Tamburin  3 , Federico Schena  3 , Massimo Venturelli  3   5
Affiliations
Randomized Controlled Trial

Comparison between physical and cognitive treatment in patients with MCI and Alzheimer's disease

Cristina Fonte et al. Aging (Albany NY). .

Abstract

Cognitive and physical activity treatments (CT and PT) are two non-pharmacological approaches frequently used in patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). The aim of this study was to compare CT and PT in these diseases. Eighty-seven patients were randomly assigned to CT (n=30), PT (n=27) or control group (CTRL; n=30) for 6 months. The global cognitive function was measured by Mini Mental State Examination (MMSE). Specific neuropsychological tests explored attention, memory, executive functions, behavioral disorders. Cardiovascular risk factors (CVD) were collected. All measures were performed before (T0), after treatments (T1), and at three-months follow-up (T2). MMSE did not change from T0 to T1 and T2 in patients assigned to PT and CT, while CTRL patients showed a decline MCI: -11.8%, AD: -16.2%). Between group differences (MCI vs AD) were not found at T1 and T2. Significant worsening was found for CTRL in MCI (T0- T1: P=.039; T0-T2: P<.001) and AD (T0-T1: P<.001; T0-T2: P<.001), and amelioration was found for CT in AD (T0-T2: P<.001). Attention, executive functions and behavioral disorders were unaffected by either PT or CT. Memory was increased in patients with MCI assigned to PT (+6.9%) and CT (+8.5%).. CVD were ameliorated in the PT group. CTRL patients of both groups, revealed significant decline in all functions and no between groups differences were detected. PT appear to ameliorate CVD. Although between groups differences were not found, results suggest a major retention in MCI compared with AD, suggesting that the latter might benefit better of constant rather than periodic treatments. This study confirms the positive effects of CT and PT in mitigating the cognitive decline in MCI and AD patients, and it is the first to demonstrate their similar effectiveness on maintaining cognitive function.

Keywords: Alzheimer’s disease; cognitive therapy; dementia; mini-mental state examination; physical activity.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors and contributors have no conflicts to declare.

Figures

Figure 1
Figure 1
Flow diagram of the randomized controlled trial. Abbreviations: MCI: Mild Cognitive Impairment; AD: Alzheimer’s Disease; M: Male; F: Female.
Figure 2
Figure 2
Primary outcome in MCI and AD. Abbreviations: MCI: Mild Cognitive Impairment; AD: Alzheimer’s Disease; PT: Physical Treatment group; CT: Cognitive Treatment group; CTRL: Control Group. Within-group comparison significant results (p ≤ 0.05): ▲ T0-T1; ■ T0-T2. Between-groups significant results (p ≤ 0.05): ★ T1 PT vs T1 CTRL; ✦ T1 CT vs T1 CTRL; ☆ T2 PT vs T2 CTRL; ✧ T2 CT vs T2 CTRL.
See this image and copyright information in PMC

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