Improving Cognitive Impairment of Elderly by an Educational Program for Their Caregivers
American Journal of Nursing Science
Volume 4, Issue 6, December 2015, Pages: 317-323
Received: Nov. 22, 2015;
Accepted: Dec. 5, 2015;
Published: Dec. 25, 2015
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Omneya Mohamed, Community Health Nursing Department, Faculty of Nursing, Zagazig University, Zagazig, Egypt
Amany Sorour, Community Health Nursing Department, Faculty of Nursing, Zagazig University, Cairo, Egypt
Amany Aboelseoud, Community Health Medicine Department, Faculty of Medicine, Zagazig University, Cairo, Egypt
Rasha Fahmy, Neurology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Cognitive impairment is associated with increased risk for progression to dementia and functional disability. The aim of this study was to examine the effectiveness of an educational program for the caregivers of elderly persons in improving their cognitive impairment. This quasi-experimental design with pre-post assessment was conducted at four geriatric care homes in Cairo governorate on 34 elderly persons having cognitive impairment (Mini-Mental State Examination [MMSE] score 19 to 24). The researchers prepared the training program for the caregivers. It included knowledge about dementia, instructions to deal with the elderly persons, and a practical part focused on memory aids. The effectiveness of the program was measured by comparing the weekly morning and evening MMSE scores, and comparing the baseline (pre-test) and 8-week (post-test) MMSE scores. The data was from August 2012 to April 2013. The results showed statistically significant improvements in elderly’s MMSE scores (p<0.001). The total MMSE score improved by 3.50 points. All elderly had cognitive impairment before the intervention; this decreased to 29.4% after the intervention (p<0.001). The improvement was markedly higher in the morning measurements compared with the evening ones. In multivariate analysis, the intervention was a statistically significant independent predictor of the improvement in the total MMSE score, in addition to the educational level. In conclusion, training the caregivers of elderly people in mental stimulation and memory aids can improve the cognitive impairment among these persons. The findings corroborate the need for developing intervention programs that equip the caregivers of elderly people with non-pharmacological management strategies that enable them to improve their cognitive impairment. Further research is needed to investigate the effectiveness of memory aids in improving the memory of elderly at different stages of dementia.
Improving Cognitive Impairment of Elderly by an Educational Program for Their Caregivers, American Journal of Nursing Science.
Vol. 4, No. 6,
2015, pp. 317-323.
Meijer W. A., van Boxtel M. P., Van Gerven P. W., van Hooren S. A., and Jolles J. (2009): Interaction effects of education and health status on cognitive change: a 6-year follow-up of the Maastricht Aging Study. Aging & Mental Health; 13: 521–529.
Coubard O.A., Ferrufino L., Boura M., Gripon A., Renaud M., and Bherer L. (2011): Atten-tional control in normal aging and Alzheimer’s disease. Neuropsychology; 25:353–367.
Fratiglioni L., and Qiu C. (2011): Prevention of cognitive decline in ageing: dementia asthe target, delayed onset as the goal. Lancet Neurology; 10: 778–779.
McGuire L. C., Ford E. S., and Ajani U. A. (2006): Cognitive functioning as a predictor offunctional disability in later life. The American Journal of Geriatric Psychiatry; 14: 36–42.
Plassman B. L., Langa K. M., Fisher G. G., Heeringa S. G., Weir, D. R., Ofstedal M. B., Burke J. R., Hurd M. D., Potter G. G., Rodgers W. L., Steffens D. C., McArdle J. J., Willis R. J., and Wallace R. B. (2008): Prevalence of cognitive impairment without dementia in the United States. Annals of Internal Medicine; 148: 427–W490.
Petersen, R. C., Caracciolo, B., Brayne C., Gauthier S., Jelic V., and Fratiglioni L. (2014): Mild cognitive impairment: a concept in evolution. Journal of Internal Medicine; 275: 214-228.
Petersen R. C., Roberts R. O., and Knopman D. S. (2009): Mild cognitive impairment: ten years later. Archives of Neurology; 66: 1447-1455.
Langa K. M. and Levine D. A. (2014): The diagnosis and management of mild cognitive impairment: a clinical review. JAMA.; 312(23): 2551-61.
Winblad B., Palmer K., Kivipelto M., Jelic V., Fratiglioni L., Wahlund L. O., Nordberg A., Bäckman L., Albert M., Almkvist O., Arai H., Basun H., Blennow K., De Leon M., Decarli C., Erkinjuntti T., Giacobini E., Graff C., Hardy J., Jack C., Jorm A., Ritchie K., Van Duijn C., Visser P., and Petersen R. C. (2004): Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine; 256: 240-246.
Coley N., Andrieu S., Gardette V., Gillette-Guyonnet S., Sanz C., Vellas B., and Grand A. (2008): Dementia prevention: methodological explantations for in consistent results. Epidemiologic Reviews; 30: 35–66.
Mangialasche F., Kivipelto M., Solomon A., and Fratiglioni L. (2012): Dementia pre-vention: current epidemiological evidence and future perspective. Alzheimer’s Research & Therapy; 4: 6.
Martin M., Clare L., Altgassen A. M., Cameron M. H., and Zehnder F. (2011): Cognition-based interventions for healthy older people and people with mild cognitiveimpairment. Cochrane Database Systematic Review; CD006220.
Reijnders J., van Heugten C., van Boxtel M. (2012): Cognitive interventions in healthyolder adults and people with mild cognitive impairment: a systematic review. Ageing Research Reviews.
Wilson R. S., Scherr P. A., Schneider J. A., Tang Y., and Bennett D. A. (2007): Relation of cognitive activity to risk of developing Alzheimer disease. Neurology; 69: 1911–1920.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975): “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician Journal of Psychiatric Research, 189–198.
World Health Organization [WHO], (2012): Alzheimer’s disease international. Dementia: A public health priority.
Delgado Derio C., Guerrero Bonnet S., Troncoso Ponce M., Araneda Yañez A., Slachevsky Chonchol A., and Behrens Pellegrino M. I. (2012): Memory, fluency, and orientation: a five-minute screening test for cognitive decline. Neurologia. 2013 Sep; 28(7): 400-7. doi: 10.1016/j.nrl.2012.10.001. Epub 2012 Dec 14.
Hall L., Orrell M., Stott J., Spector A. Cognitive stimulation therapy [CST], (2013): Mar neuropsychological mechanisms of change. Int Psychogeriatr.; 25(3):479-89
Lowenstein D. A., Acevedo A., Czaja S. J., and Duara R. (2004): Cognitive rehabilitation of mildly impaired Alzheimer disease patients on cholinesterase inhibitors. Am. J. Geriatr. Psychiatry; 395–402.
Holthoff V. A., Marschner K., Scharf M., Steding J., Meyer S., Koch R., and Donix M. (2015): Effects of physical activity training in patients with Alzheimer's dementia: results of a pilot RCT study. PLoS One.; 10(4): e0121478. doi: 10.1371/journal.pone. 0121478. eCollection 2015.
Alvaro L. (2012): Competency: general principles and applicability in dementia Neurologia; 27(5): 290-300. doi: 10.1016/j.nrl.2011.12.005. Epub 2012 Feb 17
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; 77-98.
Lacy M., Kaemmerer T., and Czipri S. (2015): Standardized mini-mental state examination scores and verbal memory performance at a memory center: implications for cognitive screening. Am J Alzheimers Dis Other Demen.; 30(2): 145-52.
Haslam C., Moss Z., and Hodder K. (2010): Are two methods better than one? Evaluating the effectiveness of combining errorless learning with vanishing cues. J. Clin. Exp. Neuropsychol.; 32: 973–985.
Belleville S., Clement F., Mellah S., Gilbert B., Fontaine F., and Gauthier S. (2011): Training-related brain Plasticity in subjects at risk of developing Alzheimer’s disease. Brain; 1623–1634.
Hampstead B. M., Stringer A. Y., Stilla R. F., Deshpande G., Hu X., Moore A. B., and Sathian K. (2011): Activation and effective connectivity changes following explicit-memory training for face- name pairs in patients with mild cognitive impairment: a pilot study. Neurorehabil Neural Repair; 210–222.
Cruz T. J., Sá S. P., Lindolpho M. D., and Caldas C. P. (2015): Cognitive stimulation for older people with Alzheimer's disease performed by the caregiver. Rev Bras Enferm.; 68(3): 510-516.
Lam L. C., Ong P. A., Dikot Y., Sofiatin Y., Wang H., Zhao M., Li W., Dominguez J., Natividad B., Yusoff S., Fu J. L., Senanarong V., Fung A. W., and Lai K. (2015): Intellectual and physical activities, but not social activities, are associated with better global cognition: a multi-site evaluation of the cognition and lifestyle activity study for seniors in Asia (CLASSA). Age Ageing.; 44(5): 835-40.
Cho M., Kim D., Chung J., Park J., You H., and Yang Y. (2015): Effects of a cognitive-enhancement group training program on daily living activities, cognition, and depression in the demented elderly. J Phys Ther Sci.; 27(3): 681-4.
Nakatsuka M., Nakamura K., Hamanosono R., Takahashi Y., Kasai M., Sato Y., Suto T., Nagatomi R., and Meguro K. (2015): A Cluster Randomized Controlled Trial of Nonpharmacological Interventions for Old-Old Subjects with a Clinical Dementia Rating of 0.5: The Kurihara Project. Dement Geriatr Cogn Dis Extra.; 5(2): 221-32.
Tse C. S., Chang J. F., Leung G. T., Fung A. W., Hau K. T., Chiu H. F., and Lam L. C. (2013): Effects of education on very mild dementia among Chinese people in Hong Kong: potential mediators in the Cantonese Mini-Mental State Examination tasks. Aging Ment Health.; 17(3): 310-8. doi: 10.1080/13607863.2012. 743962. Epub 2012 Nov 26.
Conway, Andrew R. A.; Skitka, Linda J.; Hemmerich, Joshua A.; Kershaw, Trina C. (July 2009). "Flashbulb memory for 11 September 2001". Applied Cognitive Psychology 23(5): 605–623. doi: 10.1002/acp.1497.
Spector A., Aguirre E., Woods R. T., and Orrel M. (2013): Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomized controlled trials. Ageing Res Rev; 253–262.
Devraj R., Singh VB, Ola V., Meena B. L., Tundwal V., and Singh K. (2014): Cognitive function in elderly population - An urban community based study in north-west Rajasthan. Journal, Indian Academy of Clinical Medicine; 15(2).
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. Neuropsychol. Rehabil; 20: 197–211.
Woods R. T., Whitaker R., Ballard C., Stafford J., Orrell M., Moniz-Cook E., Murray J., Knapp M., Carlton B. W., and Fossey J. (2013): Feasibility study of an optimized person- centered intervention to improve mental health and reduce antipsychotics amongst people with dementia in care homes: study protocol for a randomized Controlled trial; 13-14.
Tsolaki M., Kounti F., Agogiatou C., Poptsi E., Bakoglidou E., and Zafeiropoulou M. (2011): Effectiveness of non pharmacological approaches in patients with mild cognitive impairment. Neurodegener Dis; 138–145.
Valdez P., Ramírez C., and Garcia A. (2012): Circadian rhythms in cognitive performance: implications for neuropsychological assessment; 89.