Document Type

Article

Publication Date

2016

Abstract

Executive functions play a pivotal role in an individual’s independence. However, little research has been conducted on the efficacy of specific cognitive training for individuals with deficits consistent with mild cognitive impairment (MCI). The researchers in this study aimed to use a cognitive stimulation program that taught specific strategies to enhance the participants’ attentional and executive functional tasks. The study, using a crossover design involving two groups, included 30 participants affected by the amnestic form of MCI, executive function deficits, or both. The 6-month training sessions addressed challenges through the use of individualized cognitive strategies and proposed activities to exercise specific cognitive functions, such as shifting between two or more tasks to target cognitive flexibility. The first 2 months of the program consisted of intensive treatment, with two individual sessions per week, starting with an in-depth discussion about the difficulties each participant was experiencing. A program was then planned and discussed with the participant and caregiver, after which cognitive strategies were created and implemented. The last 4 months of the program comprised one session per week involving cognitive strategies created by the therapists and tested by the participants and caregivers in daily life activities. During the training sessions, the caregivers were actively involved and played an important role by assisting the participants in implementing strategies in the home environment.

The results showed an improvement in executive function in participants affected by MCI after they participated in the program. Moreover, the study also showed that cognitive performance can decline over time without stimulation and may only be partially recovered with the stimulation program. The data indicate that individuals affected by MCI may benefit from the cognitive stimulation program in the early stages, before a decline in cognition. Furthermore, once decline has begun, only partial recovery of the lost cognitive function may be restored through this program. This study generated several significant findings in that individuals affected by MCI can show improvement in executive function with specific cognitive stimulation. However, in recommending this cognitive stimulation program as an intervention in the field of occupational therapy, therapists should be cautious of the limitations and generalizability of this study as well as the labor-intensity demands of the intervention. Furthermore, the caregivers’ influence created a limitation on the clinical application of this study. The caregivers were very involved in this study; however, almost no information was given regarding their characteristics.

Comments

Originally published as: Wilson, A., Zaw, Y., Isely, M., & Li, K. (2016). Critically Appraised Paper for “Cognitive stimulation of executive functions in mild cognitive impairment: Specific efficacy and impact in memory” American Journal Of Alzheimer's Disease And Other Dementias, 30(2), 299-306. Bethesda, MD: American Occupational Therapy Association, Evidence-Based Practice Project.

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