Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease

Objective: To evaluate the efficacy of a cognitive-motor program in patients with early Alzheimer disease ( AD) who are treated with a cholinesterase inhibitor (ChEI). Methods: Patients with mild cognitive impairment (MCI) (12), mild AD ( 48), and moderate AD ( 24) ( Global Deterioration Scale stages 3, 4, and 5) were randomized to receive psychosocial support plus cognitive-motor intervention ( experimental group) or psychosocial support alone ( control group). Cognitive-motor intervention (CMI) consisted of a 1-year structured program of 103 sessions of cognitive exercises, plus social and psychomotor activities. The primary efficacy measure was the cognitive subscale of the AD Assessment Scale (ADAS-cog). Secondary efficacy measures were the Mini-Mental State Examination, the Functional Activities Questionnaire, and the Geriatric Depression Scale. Evaluations were conducted at 1, 3, 6, and 12 months by blinded evaluators. Results: Patients in the CMI group maintained cognitive status at month 6, whereas patients in the control group had significantly declined at that time. Cognitive response was higher in the patients with fewer years of formal education. In addition, more patients in the experimental group maintained or improved their affective status at month 12 (experimental group, 75%; control group, 47%; p = 0.017). Conclusions: A long-term CMI in ChEI-treated early Alzheimer disease patients produced additional mood and cognitive benefits.