Mild Cognitive Impairment Clinical Trial
Official title:
Cognitive Intervention for Persons With Amnestic Mild Cognitive Impairment: The Efficacy in Enhancement of Cognition and Complex Activities of Daily Living Function
People with mild cognitive impairment (MCI) are at a greater risk of developing dementia.
Therefore, it is important to develop effective non-pharmacological interventions to
facilitate their cognitive and activities of daily living (ADL) function, which will also
prevent or delay their progression to dementia and reduce associated healthcare and social
costs. There are currently a variety of cognitive interventions, mainly categorized as
remediation and rehabilitation approach. Research to compare their contents and effectiveness
is strongly needed. The information can be used to individualize cognitive intervention based
on specific cognitive profile of the patient.
This study aims to determine the immediate and long-term efficacy of the remediation approach
and rehabilitation approach in enhancing the cognitive and ADL function. The research
questions include 1) whether the rehabilitation approach compared with the remediation
approach has better effects on improving ADL function; (2) whether the remediation approach
may only enhance the performance on the cognitive tests rather than on the ADL function. This
study will also explore whether the attitudes of caregivers on providing ADL assistance
affect effects of cognitive intervention.
The study is designed by a single-blinded randomized control trial. Sixty persons with MCI,
confirmed by physicians, will receive 12 weekly 90-minute cognition interventions in a group
of 6-8 persons. All participants will be randomly assigned to the following groups: 1)
Remediation approach: various cognitive strategies will be taught, and exercises involving
the practice of these strategies to enhance the attention, memory, processing speed, and
executive functions. 2) Combination of rehabilitation and remediation approaches: The first
half of each session will focus on the remediation approach as described above. The second
half of the session will apply rehabilitation approach. The investigators will use group
discussion to discuss everyday situations with memory problem and specific strategies
(internal and external) related to real-life situations. The investigators will also include
one individual session in the 12 group sessions.
All participants will be assessed at 3 time points: before intervention, right after
intervention, and 12 weeks after the intervention. The primary outcomes are the ADL functions
evaluated by subjective and objective measures, and cognitive function evaluated by tests of
attention, memory and executive function. The secondary outcomes include the depression, the
quality of life of the participants, and the caregivers' load. The intervention effects will
be further analyzed by the caregivers' attitude regarding to the level of ADL assistance.
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