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Review Article
February 2013

An Evidence-Based Systematic Review on Cognitive Interventions for Individuals With Dementia

Publication: American Journal of Speech-Language Pathology
Volume 22, Number 1
Pages 126-145

Abstract

Purpose

To evaluate the current state of research evidence related to cognitive interventions for individuals with Alzheimer’s disease or related dementias.

Method

A systematic search of the literature was conducted across 27 electronic databases based on a set of a priori questions, inclusion/exclusion criteria, and search parameters. Studies were appraised for methodological quality and categorized according to intervention technique and outcome (e.g., cognitive-communication impairment or activity limitation/participation restriction). Results were summarized and, when possible, analyzed quantitatively using indicators of treatment effect size.

Results

Forty-three studies met criteria for inclusion in the review. The most commonly used cognitive intervention techniques used were errorless learning, spaced-retrieval training, vanishing cues, or verbal instruction/cueing. Most treatment outcomes were measured at the cognitive-communication impairment level of functioning and were generally positive. However, results should be interpreted cautiously because of methodological limitations across studies.

Conclusions

Research evidence to support the use of cognitive interventions for individuals with dementia is accumulating. Researchers are beginning to evaluate treatment efficacy, yet the focus tends to be on discovery, specifically, refining intervention variables that will facilitate optimal outcomes. Implications for clinical practice and avenues for future research are discussed.

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References

References marked with an asterisk indicate studies included in the evidence-based systematic review.
Alzheimer’s Association 2012 Alzheimer’s disease facts and figures Chicago, IL Author Retrieved from http://www.alz.org/national/documents/Facts_Figures_2011.pdf
American Psychiatric Association 1994 Diagnostic and statistical manual of mental disorders 4th ed. Washington, DC Author
American Speech-Language-Hearing Association 2005 Knowledge and skills needed by speech-language pathologists providing services to individuals with cognitive-communication disorders Rockville, MD Author Retrieved from http://www.asha.org/policy/KS2005-00078.htm
American Speech-Language-Hearing Association 2007 Scope of practice in speech-language pathology Retrieved from http://www.asha.org/docs/html/SP2007-00283.html
American Speech-Language-Hearing Association 2011 SLP healthcare survey 2011: Caseload characteristics Rockville, MD Author
*Andrews-Salvia M., Roy N., and Cameron R. M. 2003 Evaluating the effects of memory books for individuals with severe dementia Journal of Medical Speech-Language Pathology 11 51 -59
Auer S. and Reisberg B. 1995 Modified Ordinal Scales of Psychological Development New York, NY Aging and Dementia Research Center, New York University Medical Center
*Balota D. A., Duchek J. M., Sergent-Marshall S. D., and Roediger H. L. III. 2006 Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer’s disease Psychology and Aging 21 19 -31
Bayles K., Kim E., Azuma T., Chapman S., Cleary S., Hopper T., and … Zientz J. 2005 Developing evidence-based practice guidelines for speech-language pathologists serving individuals with Alzheimer’s dementia Journal of Medical Speech-Language Pathology 13 xiii -xxv
Bayles K., Kim E., Chapman S. B., Zientz J., Rackley A., Mahendra N., and … Cleary S. 2006 Evidence-based practice recommendations for working with individuals with dementia: Simulated presence therapy Journal of Medical Speech-Language Pathology 14 xiii -xxi
Benedict R. 1997 Brief Visuospatial Memory Test—Revised professional manual Odessa, FL Psychological Assessment Resources
Benedict R., Schretlen D., Groninger L., and Brandt J. 1998 Hopkins Verbal Learning Test—Revised: Normative data and analysis on inter-form and test–retest reliability The Clinical Neuropsychologist 12 43 -55
*Bier N., Provencher V., Gagnon L., Van der Linden M., Adam S., and Desrosiers J. 2008 New learning in dementia: Transfer and spontaneous use of learning in everyday life functioning. Two case studies Neuropsychological Rehabilitation 18 204 -235
Bourgeois M. S. and Hickey E. M. 2009 Dementia: From diagnosis to management—A functional approach New York, NY Psychology Press
*Cahn-Weiner D. A., Malloy P. F., Rebok G. W., and Ott B. R. 2003 Results of a randomized placebo-controlled study of memory training for mildly impaired Alzheimer’s disease patients Applied Neuropsychology 10 215 -223
Camp C., Judge K., Bye C., Fox K., Bowden J., Bell M., and … Mattern J. M. 1997 An intergenerational program for persons with dementia using Montessori methods The Gerontologist 37 688 -692
Camp C. and Stevens A. 1990 Spaced-retrieval: A memory intervention for dementia of the Alzheimer’s type Journal of Aging and Mental Health 10 58 -61
Chapman S., Weiner M., Rackley A., Hynan L., and Zientz J. 2004 Effects of cognitive-communication stimulation for Alzheimer’s disease patients treated with donepezil Journal of Speech, Language, and Hearing Research 47 1149 -1163
Cherney L., Patterson J. P., Raymer A., Frymark T., and Schooling T. 2008 Evidence-based systematic review: Effects of intensity of treatment and constraint-induced language therapy for individuals with stroke-induced aphasia Journal of Speech, Language, and Hearing Research 51 1282 -1299
*Cherry K. E., Hawley K. S., Jackson E. M., and Boudreaux E. O. 2009 Booster sessions enhance the long-term effectiveness of spaced retrieval in older adults with probable Alzheimer’s disease Behavior Modification 33 295 -313
*Cherry K. E. and Simmons-D’Gerolamo S. S. 2005 Long-term effectiveness of spaced-retrieval memory training for older adults with probable Alzheimer’s disease Experimental Aging Research 31 261 -289
Clare L. and Jones R. 2008 Errorless learning in the rehabilitation of memory: A critical review Neuropsychological Review 18 1 -23
*Clare L., Linden D. E., Woods R. T., Whitaker R., Evans S. J., Parkinson C. H., and … Rugg M. 2010 Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: A single-blind randomized controlled trial of clinical efficacy American Journal of Geriatric Psychiatry 18 928 -939
Clare L. and Woods B. 2008 Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD003260. (Original work published 2003)
Clark L. W. 1995 Interventions for persons with Alzheimer’s disease: Strategies for maintaining and enhancing communicative success Topics in Language Disorders 15 47 -66
Cohen J. 1960 A coefficient of agreement for nominal scales Educational Psychological Measurement 20 37 -46
Cohen J. 1992 A power primer Psychological Bulletin 112 155 -159
*Dunn J. and Clare L. 2007 Learning face–name associations in early-stage dementia: Comparing the effects of errorless learning and effortful processing Neuropsychological Rehabilitation 17 735 -754
Egan M., Bérubé D., Racine G., Leonard C., and Rochon E. 2010 Methods to enhance communication between individuals with Alzheimer’s disease and their caregivers: A systematic review International Journal of Alzheimer’s Disease 2010 1 -12
Feise R. 2002 Do multiple outcome measures require p-value adjustment? BMC Medical Research Methodology 2 8
Folstein M., Folstein S., and McHugh P. 1975 “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician Journal of Psychiatric Research 12 189 -198
Glisky E. L., Schacter D., and Tulving E. 1986 Learning and retention of computer-related vocabulary in memory impaired patients: Method of vanishing cues Journal of Clinical and Experimental Neuropsychology 8 292 -312
*Haslam C., Gilroy D., Black S., and Beesley T. 2006 How successful is errorless learning in supporting memory for high and low-level knowledge in dementia? Neuropsychological Rehabilitation 16 505 -536
*Haslam C., Moss Z., and Hodder K. 2010 Are two methods better than one? Evaluating the effectiveness of combining errorless learning with vanishing cues Journal of Clinical and Experimental Neuropsychology 32 973 -985
*Hawley K. S., Cherry K. E., Boudreaux E. O., and Jackson E. M. 2008 A comparison of adjusted spaced retrieval versus a uniform expanded retrieval schedule for learning a name–face association in older adults with probable Alzheimer’s disease Journal of Clinical and Experimental Neuropsychology 30 639 -649
Hebert L. E., Scherr P. A., Bienias J., Bennett D., and Evans D. A. 2003 Alzheimer disease in the US population: Prevalence estimates using the 2000 census Archives of Neurology 60 1119 -1122
*Hochhalter A. K., Bakke B. L., Holub R. J., and Overmier J. B. 2004 Adjusted spaced retrieval training: A demonstration and initial test of why it is effective Clinical Gerontologist 27 159 -168
*Hochhalter A. K., Overmier J. B., Gasper S. M., Bakke B. L., and Holub R. J. 2005 A comparison of spaced retrieval to other schedules of practice for people with dementia Experimental Aging Research 31 101 -118
Hopper T. 2001 Indirect interventions in Alzheimer’s disease Seminars in Speech and Language 22 305 -315
Hopper T., Mahendra N., Kim E., Azuma T., Bayles K., Cleary S., and Tomoeda C. K. 2005 Evidence-based practice recommendations for working with individuals with dementia: Spaced retrieval training Journal of Medical Speech-Language Pathology 13 xxvii -xxxiv
Huppert F., Brayne C., Gill C., Paykel E., and Beardsall L. 1995 CAMCOG—A concise neuropsychological test to assist dementia diagnosis: Socio-demographic determinants in an elderly population sample British Journal of Clinical Psychology 34 529 -541
*Kessels R. P. and Olde Hensken L. M. 2009 Effects of errorless skill learning in people with mild-to-moderate or severe dementia: A randomized controlled pilot study NeuroRehabilitation 25 307 -312
Kim E., Cleary S., Hopper T., Bayles K. A., Mahendra N., Azuma T., and Rackley A. 2006 Evidence-based practice recommendations for working with individuals with dementia: Group reminiscence therapy Journal of Medical Speech-Language Pathology 14 xxiii -xxxiv
*Kinsella G. J., Ong B., Storey E., Wallace J., and Hester R. 2007 Elaborated spaced-retrieval and prospective memory in mild Alzheimer’s disease Neuropsychological Rehabilitation 17 688 -706
*Laffan A. J., Metzler-Baddeley C., Walker I., and Jones R. W. 2010 Making errorless learning more active: Self-generation in an error free learning context is superior to standard errorless learning of face–name associations in people with Alzheimer’s disease Neuropsychological Rehabilitation 20 197 -211
*Lancioni G. E., La Martire M. L., Singh N. N., O’Reilly M. F., Sigafoos J., Pinto K., and Minervini M. 2009 Persons with mild or moderate Alzheimer’s disease managing daily activities via verbal instruction technology American Journal of Alzheimer’s Disease & Other Dementias 23 552 -562
*Lancioni G., Pinto K., La Martire M., Tota A., Rigante V., Tatulli E., and … Oliva D. 2009 Helping persons with mild or moderate Alzheimer’s disease recapture basic daily activities through the use of an instruction strategy Disability and Rehabilitation 31 211 -219
*Lancioni G. E., Singh N. N., O’Reilly M. F., Sigafoos J., Pangrazio M. T., Megna M., and … Minervini M. 2009 Persons with moderate Alzheimer’s disease improve activities and mood via instruction technology American Journal of Alzheimer’s Disease & Other Dementias 24 246 -257
*Lancioni G. E., Singh N. N., O’Reilly M. F., Sigafoos J., Tatulli E., Rigante V., and … Minervini M. 2010 Technology-aided verbal instructions to help persons with mild or moderate Alzheimer’s disease perform daily activities Research in Developmental Disabilities 31 1240 -1250
Landis J. R. and Koch G. G. 1977 The measurement of observer agreement for categorical data Biometrics 33 159 -174
Lawton M. and Brody E. 1969 Assessment of older people: Self-maintaining and instrumental activities of daily living The Gerontologist 9 176 -185
*Lekeu F., Wojtasik V., Van der Linden M., and Salmon E. 2002 Training early Alzheimer patients to use a mobile phone Acta Neurology Belgium 102 114 -121
*Loewenstein D. A., Acevedo A., Czaja S. J., and Duara R. 2004 Cognitive rehabilitation of mildly impaired Alzheimer disease patients on cholinesterase inhibitors American Journal of Geriatric Psychiatry 12 395 -402
Mahendra N., Hopper T., Bayles K., Azuma T., Cleary S., and Kim E. 2006 Evidence-based practice recommendations for working with individuals with dementia: Montessori-based interventions Journal of Medical Speech-Language Pathology 14 xv -xxv
Mahendra N., Kim E., Bayles K., Hopper T., Cleary S., and Azuma T. 2005 Evidence-based practice recommendations for working with individuals with dementia: Computer-assisted cognitive interventions Journal of Medical Speech-Language Pathology 13 xxxv -xliv
*Marshall R. C., Capilouto G. J., and McBride J. M. 2007 Treatment of problem solving in Alzheimer’s disease: A short report Aphasiology 21 235 -247
Marshall R., Karow C., Morelli C., Iden K., and Dixon J. 2003 A clinical measure for the assessment of problem solving in brain-injured adults American Journal of Speech-Language Pathology 12 333 -348
Mattis S. 1988 Dementia Rating Scale: Professional manual Odessa, FL Psychological Assessment Resources
McGraw K. and Wong S. 1992 A common language effect size statistic Psychological Bulletin 111 361 -365
McKhann G., Drachman D., Folstein M., Katzman R., Price D., and Stadlan E. M. 1984 Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS–ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease Neurology 34 939 -944
Metzler-Baddeley C. and Snowden J. S. 2005 Brief report: Errorless versus errorful learning as a memory rehabilitation approach in Alzheimer’s Disease Journal of Clinical Neuropsychology 27 1070 -1079
*Mimura M. and Komatsu S. I. 2010 Factors of error and effort in memory intervention for patients with Alzheimer’s disease and amnesic syndrome Psychogeriatrics 10 179 -186
*Neely A. S., Vikstrom S., and Josephsson S. 2009 Collaborative memory intervention in dementia: Caregiver participation matters Neuropsychological Rehabilitation 19 696 -715
Olazarán J., Reisberg B., Clare L., Cruz I., Peña-Casanova J., Del Ser T., and … Muñiz R. 2010 Nonpharmacological therapies in Alzheimer’s disease: A systematic review of efficacy Dementia and Geriatric Cognitive Disorders 30 161 -178
*Oriani M., Moniz-Cook E., Binetti G., Zanieri G., Frisoni G. B., Geroldi C., and … Zanetti O. 2003 An electronic memory aid to support prospective memory in patients in the early stages of Alzheimer’s disease: A pilot study Aging & Mental Health 7 22 -27
Parker R. and Vannest K. 2009 An improved effect size for single-case research: Nonoverlap of all pairs Behavior Therapy 40 357 -367
Reitan R. and Wolfson D. 1995 Category Test and Trail Making Test as measures of frontal lobe functions The Clinical Neuropsychologist 9 50 -56
Ritchie K. and Lovenstone S. 2002 The dementias The Lancet 360 1759 -1766
*Ruis C. and Kessels R. P. 2005 Effects of errorless and errorful face–name associative learning in moderate to severe dementia Aging Clinical and Experimental Research 17 514 -517
Siegel S. and Castellari N. 1988 Nonparametric statistics 2nd ed. New York, NY McGraw-Hill
Sohlberg M. M., Ehlhardt L., and Kennedy M. 2005 Instructional techniques in cognitive rehabilitation: A preliminary report Seminars in Speech and Language 26 268 -279
*Souchay C., Moulin C. J., Isingrini M., and Conway M. A. 2008 Rehearsal strategy use in Alzheimer’s disease Cognitive Neuropsychology 25 783 -797
Sunderland A., Harris J., and Baddely A. 1983 Do laboratory test predict everyday memory? A neuropsychological study Journal of Verbal Learning and Verbal Behavior 22 341 -357
*Thivierge S., Simard M., Jean L., and Grandmaison É. 2008 Errorless learning and spaced retrieval techniques to relearn instrumental activities of daily living in mild Alzheimer’s disease: A case report study Neuropsychiatric Disease and Treatment 4 987 -999
*Tsantali E., Tsolaki M., and Economides D. 2009 The effects of a cognitive training program on trained and untrained cognitive functions of non-demented elderly and Alzheimer’s patients International Journal of Psychosocial Rehabilitation 14 77 -98
*Vance D. E. and Johns R. N. 2002 Montessori improved cognitive domains in adults with Alzheimer’s disease Physical & Occupational Therapy in Geriatrics 20 19 -36
Wechsler D. 1981 Wechsler Adult Intelligence Scale New York, NY Psychological Corporation
Wilson B. 2002 Towards a comprehensive model of cognitive rehabilitation Neuropsychological Rehabilitation 12 97 -110
Wilson B., Cockburn J., and Baddeley A. 1985 The Rivermead Behavioural Memory Test Fareham, Hampshire, UK Thames Valley Test Company
World Health Organization 2001 International classification of functioning, disability and health Geneva, Switzerland Author
Zientz J., Rackley A., Chapman S. B., Hopper T., Mahendra N., and Cleary S. 2007 Evidence-based practice recommendations for dementia: Caregiver-administered active cognitive stimulation for individuals with Alzheimer’s disease Journal of Medical Speech-Language Pathology 15 liii -liv
Zientz J., Rackley A., Chapman S. B., Hopper T., Mahendra N., Kim E., and Cleary S. 2007 Evidence-based practice recommendations for dementia: Educating caregivers about Alzheimer’s disease and training communication strategies Journal of Medical Speech-Language Pathology 15 liii -lxiv

Information & Authors

Information

Published In

American Journal of Speech-Language Pathology
Volume 22Number 1February 2013
Pages: 126-145

History

  • Received: Nov 4, 2011
  • Accepted: Jun 24, 2012
  • Published in issue: Feb 1, 2013

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Key Words

  1. Alzheimer’s disease
  2. dementia
  3. cognitive intervention
  4. speech-language pathology

Authors

Affiliations

Tammy Hopper
University of Alberta, Edmonton, Alberta, Canada
Michelle Bourgeois
Jane Pimentel
Eastern Washington University, Spokane
Constance Dean Qualls
State University of New York College at Buffalo
Ellen Hickey
Dalhousie University, Halifax, Nova Scotia, Canada
Tobi Frymark
American Speech-Language-Hearing Association, Rockville, MD
Tracy Schooling
American Speech-Language-Hearing Association, Rockville, MD

Notes

Correspondence to Tobi Frymark: [email protected]
Editor: Carol Scheffner Hammer
Associate Editor: Heather Wright

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