Predictors of comprehensive stimulation program efficacy in patients with cognitive impairment. Clinical practice recommendations

Background The aim of the present study was to identify which factors may predict the best response to a comprehensive stimulation program in patients with dementia and mild cognitive impairment (MCI) as well as in their caregivers. Methods A six-month longitudinal study has been performed on 145 patients (55 with MCI and 90 with dementia), participating to a cognitive motor rehabilitation program, and their 131 caregivers, attending informational/psychoeducational interventions. Mini mental state examination, Alzheimer's Disease Assessment ScaleCognition, and Clinician's Interview-Based Impression of Change-plus were used as primary outcome measures. Results Sixty-eight (46.9%) of the 145 subjects were classified as clinical responders. At baseline, responders had a significant less insight impairment, larger functional ability as well as less delusions, euphoria, and aberrant motor behaviors than the non-responder. After 6?months along with an improvement in cognition, responders showed decrease in behavioral disturbances and severity of the disturbances. During the 6?months of analysis, stability has been observed in caregiver's burden distress. After 6?months, the caregivers of MCI responders have their burden reduced. Conclusions The high level of insight, the preserved functional abilities as well as the lack of severe delusions, euphoria, and aberrant motor behaviors are significant predictors of responsiveness to stimulation program. Copyright (c) 2012 John Wiley & Sons, Ltd.