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Long-Term Observation of a Multicomponent Cognitive Intervention in Mild Cognitive Impairment

J Clin Psychiatry 2012;73(12):e1492-e1498
10.4088/JCP.11m07270

Background: Recent studies demonstrated benefits of cognitive intervention in mild cognitive impairment (MCI), but few studies have determined long-term effects on cognition, conversion rate to Alzheimer’s disease, and the role of early intervention.

Method: A 6-month multicomponent cognitive group intervention was applied in participants with single- or multiple-domain amnestic MCI (defined according to Petersen’s criteria). One group (n = 12) received the intervention at the beginning of the study period and was compared with an active control group (n = 12) who received it after an 8-month time lag. Follow-up assessments were conducted at 15 and 28 months (study period was August 2007–December 2009). The primary outcome was change in cognitive function as determined by changes in scores on the Mini-Mental State Examination and the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog), and the secondary outcomes were change in specific cognitive and noncognitive functions and conversion to Alzheimer’s disease (according to DSM-IV/NINCDS-ADRDA criteria and NAI-AA criteria for probable Alzheimer’s dementia with increased level of certainty).

Results: Eighteen participants completed the study after 28 months. Long-term data revealed a stable intervention effect on the primary outcome ADAS-cog in the early-intervention group (P = .024). The participants in the later-intervention (control) group appeared to benefit to a lesser extent from the cognitive intervention compared to those who received it earlier. Only participants in the later-intervention group (6 of 12) converted to Alzheimer’s disease during the 28-month study period.

Conclusions: Benefits of our 6-month cognitive intervention on global cognitive status appear to be preserved over extended follow-up periods. Early cognitive intervention may delay conversion to Alzheimer’s disease. Findings in a small sample encourage the use of the intervention in larger-scale studies.

Trial Registration: ClinicalTrials.gov identifier: NCT00544856

J Clin Psychiatry 2012;73(12):e1492–e1498

Submitted: July 15, 2011; accepted October 2, 2012 (doi:10.4088/JCP.11m07270).

Corresponding author: Verena C. Buschert, PhD, Kbo-Inn-Salzach Klinikum, Psychiatric Hospital, Gabersee Haus 13, D-83512 Wasserburg/Inn, Germany (verena.buschert@iskl.de).