Effect of Integrated Cognitive Intervention Therapy in Patients with Mild to Moderate Alzheimer's Disease

Abstract

Background and purpose: The effect of the integrated program comprising cognitive training, art therapy, and music therapy has not been extensively studied in patients with Alzheimer's disease (AD). The present study investigated the effect of integrated cognitive intervention therapy on cognition, and activity of daily life (ADL), and mood in patients with mild to moderate AD.

Methods: In this study, the data of 59 patients who met the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer disease and Related Disorders Association (NINCDS-ADRDS) criteria of probable AD among those who registered at the Centenarian's Good Memory Program in Goyang from September 2014 to August 2019 were collected. We statistically analyzed the scores of Korean version of a Mini-Mental Status Examination (K-MMSE), Korean Dementia Screening Questionnaire-Cognition (KDSQ-C), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Seoul-Instrumental Activities of Daily Living (S-IADL) of the same patients before and after the use of integrated cognitive intervention therapy.

Results: K-MMSE slightly increased from 18.7±4.5 to 19.7±5.0 (p<0.001) and KDSQ-C improved from 14.5±7.6 before therapy to 12.6±7.2 after therapy (p=0.001). Mean S-IADL score improved from 17.6±7.6 before therapy to 15.7±9.5 after therapy (p<0.001). Additionally, mean GDS score before the therapy was 5.6±3.5 that improved to 4.2±3.0 after the therapy (p<0.001). Mean BAI score decreased from 8.4±10.3 before therapy to 5.9±8.4 after therapy (p=0.001).

Conclusions: In conclusion, this study demonstrated the possibility that the use of an integrated cognitive therapy improved cognition, ADL, and mood (depression and anxiety) in patients with mild to moderate ADs.

Keywords: Alzheimer's Disease; Art Therapy; Music Therapy.

Fig. 1. Comparison of neuropsychological examination result between pre- and post-therapy.

Each neuropsychological scale improved after integrated cognitive intervention therapy. The Wilcoxon rank test was performed for comparing pre- and post-therapy scores. Where noted p indicates p-value for the Wilcoxon rank test. K-MMSE: Korean version of Mini Mental Status Examination, KDSQ-C: Korean version of Dementia Screening Questionnaire-Cognition, S-IADL: Seoul-Instrumental Activity of Daily Life, GDS: Geriatric Depression Scale, BAI: Beck Anxiety Inventory.