Multimodal Cognitive Enhancement Therapy for Patients with Mild Cognitive Impairment and Mild Dementia: A Multi- Center, Randomized, Controlled, Double-Blind, Crossover Trial

Article type: Research Article

Authors: Han, Ji Won^a | Lee, Hyeonggon^b | Hong, Jong Woo^a | Kim, Kayoung^a | Kim, Taehyun^a | Byun, Hye Jin^a | Ko, Ji Won^a | Youn, Jong Chul^c | Ryu, Seung-Ho^d | Lee, Nam-Jin^e | Pae, Chi-Un^f | Kim, Ki Woong^{a; g; h; *}

Affiliations: [a] Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea | [b] Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea | [c] Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea | [d] Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea | [e] Department of Psychiatry, Jeonju City Welfare Hospital for the Elderly, Jeonju, Korea | [f] Department of Psychiatry, Bucheon St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea | [g] Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea | [h] Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea

Correspondence: [*] Correspondence to: Ki Woong Kim, MD, PhD, Department of Neuropsychiatry, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundanggu, Seongnamsi, Gyeonggido 463-707, Korea. Tel.: +82 31 787 7432; Fax: +82 31 787 4058; E-mail: kwkimmd@snu.ac.kr.

Abstract: We developed and evaluated the effect of Multimodal Cognitive Enhancement Therapy (MCET) consisting of cognitive training, cognitive stimulations, reality orientation, physical therapy, reminiscence therapy, and music therapy in combination in older people with mild cognitive impairment (MCI) or mild dementia. This study was a multi-center, double-blind, randomized, placebo-controlled, two-period cross-over study (two 8-week treatment phases separated by a 4-week wash-out period). Sixty-four participants with MCI or dementia whose Clinical Dementia Rating was 0.5 or 1 were randomized to the MCET group or the mock-therapy (placebo) group. Outcomes were measured at baseline, week 9, and week 21. Fifty-five patients completed the study. Mini-Mental State Examination (effect size = 0.47, p = 0.013) and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (effect size = 0.35, p = 0.045) scores were significantly improved in the MCET compared with mock-therapy group. Revised Memory and Behavior Problems Checklist frequency (effect size = 0.38, p = 0.046) and self-rated Quality of Life – Alzheimer’s Disease (effect size = 0.39, p = 0.047) scores were significantly improved in the MCET compared with mock-therapy. MCET improved cognition, behavior, and quality of life in people with MCI or mild dementia more effectively than conventional cognitive enhancing activities did.

Keywords: Cognitive interventions, cognitive therapy, cognitive training, dementia, mild cognitive impairment, mild dementia, multimodal cognitive enhancement therapy, non-pharmacologic treatment, randomized controlled trials

DOI: 10.3233/JAD-160619

Journal: Journal of Alzheimer's Disease, vol. 55, no. 2, pp. 787-796, 2017