American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

National Institute of Mental Health; Department of Veterans Affairs
Cognitive Training in Alzheimer's Disease: A Meta-Analysis of the Literature

Sitzer, D. I., Twamley, E. W., et al. (2006).
Acta Psychiatr Scand, 114(2), 75-90.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a meta-analysis of controlled trials that examined the effects of cognitive training, including restorative and compensatory treatments, to improve the cognitive performance of individuals with Alzheimer’s disease.

Question(s) Addressed:

Question not specifically stated.

Population: Alzheimer’s disease patients or patients with probable Alzheimer’s disease.

Intervention/Assessment: Cognitive training (including a comparison of restorative and compensatory strategies)

Number of Studies Included: 17

Years Included: 1840 to 2004

Findings:

Conclusions:

  • Treatment
    • Cognitive-Communication
      • Compensatory Treatments - "Compensatory techniques (e.g. visualization, procedural memory training, and external devices) appeared to be less effective than restorative strategies at improving cognitive and functional abilities" (p. 87).
      • Restorative Treatments
        • The results from 19 controlled trials suggest that cognitive training can improve cognitive and functional abilities. A wide range of effect sizes from small 0.2 to large >0.8 were reported.
        • Cognitive training appears to have the greatest effect on the outcome of performance-based ADLs.
        • Limited follow-up data suggest that effects of cognitive training may be maintained for an average of 4.5 months post treatment. (pages 86-87).
        • "The most efficacious CT interventions were those that used restorative strategies, such as general cognitive stimulation (e.g. prompting recall of remote memories, practicing conversation skills, problem solving, reading, and engaging in creative activities), computerized visuospatial drills, and memory drills emphasizing repetition" (p. 87).
        • "Compensatory techniques (e.g. visualization, procedural memory training, and external devices) appeared to be less effective than restorative strategies at improving cognitive and functional abilities" (p. 87).
  • Service Delivery
    • Format
      • Individual cognitive training sessions appear to be more effective than group sessions.

Keywords: Alzheimer's Disease, Cognition

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Added to Compendium: December 2011

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