29/07/2016

AlzheimerDisease:CognitiveIntervention:AbstractandIntroduction

Edition:EnglishDeutschEspaolFranaisPortugus

MULTISPECIALTY

CognitiveInterventioninAlzheimer
Disease
VerenaBuschertArunL.W.Bokde,PhDHaraldHampel,MD Facultyand
Disclosures
CMEReleased:08/17/2010Validforcreditthrough08/17/2011
CMEInformation

ABSTRACTANDINTRODUCTION

1.

Abstract

2.NeuronalPlasticity

Alzheimerdisease(AD)isoneofthemostprevalentchronic
medicalconditionsaffectingtheelderlypopulation.The
effectivenessofapprovedantidementiadrugs,however,islimited
licensedADmedicationsprovideonlymoderatereliefofclinical
symptoms.Cognitiveinterventionisanoninvasivetherapythat
couldaidpreventionandtreatmentofAD.Datasuggestthat
specificallydesignedcognitiveinterventionscouldimpart
therapeuticbenefitstopatientswithADthatareassociatedwith
substantialbiologicalchangeswithinthebrain.Moreover,
evidenceindicatesthatacombinationofpharmacologicandnon
pharmacologicinterventionscouldprovidegreaterreliefofclinical

AbstractandIntroduction

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3.CognitiveReserveandBrainReserve
4.PhysicalExercise
5.TermsandDefinitions
6.CognitiveTraininginHealthyElderly
7.CognitiveIntervention
8.NeuroimagingStudies
9.ImplicationsforFutureStudies
10.RecommendationsforPractice
11.Conclusions
12.KeyPoints
References

symptomsthaneitherinterventiongivenalone.Functionaland
structuralMRIstudieshaveincreasedourunderstandingoftheunderlyingneurobiologicalmechanismsofagingand
neurodegeneration,buttheuseofneuroimagingtoinvestigatetheeffectofcognitiveinterventiononthebrain
remainslargelyunexplored.ThisReviewprovidesanoverviewoftheuseofcognitiveinterventioninthehealthy
elderlypopulationandpatientswithAD,andsummarizesemergingfindingsthatprovideevidenceforthe
effectivenessofthisapproach.Finally,wepresentrecommendationsforfutureresearchontheuseofcognitive
interventionsinADanddiscusspotentialeffectsofthistherapyondiseasemodification.
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29/07/2016

AlzheimerDisease:CognitiveIntervention:AbstractandIntroduction

Introduction
Alzheimerdisease(AD)isoneofthemostdevastatingandprevalentchronicmedicalconditionsinelderlyindividuals.
[1]Atpresent,noapproveddiseasemodifyingdrugsareavailableforthiscondition.Licensedantidementiadrugs,

suchascholinesteraseinhibitors(ChEIs)andmemantineanNmethylDaspartatereceptorantagonistprovide
onlylimitedrelieffromclinicalsymptomsand,onaverage,delaycognitivedeclinebyonly612months.[2]Thus,new
therapeuticstrategiesareurgentlyneededthatrobustlyinhibittheclinicalsymptomsofADandattenuatedisease
progression.Cognitiveinterventionseemstobeanemergingtherapeuticapproachthatcouldaidpreventionand
treatmentofthisdisease.Researchsuggeststhatregularactivationofvariousbrainnetworksbycognitiveand/or
physicalstimulationcouldconsiderablycontributetobrainhealthandcognitivestatus.[3,4]Moreover,approachesthat
combinepharmacologicandnonpharmacologicinterventionsmighteffectivelysupportcognitive,affectiveand
functionalabilitiesinpatientswithpreclinicalorclinicalAD.ComparedwithpharmacologictreatmentofAD,cognitive
interventionsarelikelytobelessexpensiveandmorecosteffective,[5]inaddition,cognitiveinterventionisthoughtto
causenoadverseevents.[6]
Inthisarticle,wereviewtheuseofcognitiveinterventioninhealthyelderlyindividualsandpatientswithpreclinicalor
clinicalAD,andprovideanoverviewofrecentstudiesthatsuggestthatcognitiveinterventionprovidessubstantial
benefitsforpatientswiththiscondition.Wealsopresentrecommendationsforfutureresearchontheuseofcognitive
interventionsinADanddiscusshowthisnonpharmacologictreatmentcanmodifyclinicalsymptomsassociatedwith
thisdisease.
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AlzheimerDisease:CognitiveIntervention:AbstractandIntroduction

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