High-Ecological Cognitive Intervention to Improve Cognitive Skills and Cognitive-Functional Performance for Older Adults With Mild Cognitive Impairment.

Ling-Hui Chang, Po-Yen Chen, Jye Wang, Bin-Huei Shih, Yu-Hsuan Tseng, Hui-Fen Mao

Journal: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 2021;75(5):7505205050

PMID: 34780638

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Abstract

IMPORTANCE

Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited.

OBJECTIVE

To examine the efficacy of a high-ecological cognitive intervention.

DESIGN

Quasi-experimental, pretest-posttest design with nonequivalent control.

SETTING

Community.

PARTICIPANTS

Older adults with mild cognitive impairment from two senior centers.

INTERVENTION

Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group). Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT-Im] and Delayed Recall [CMT-De] tasks), and the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive-functional performance was measured with the Rivermead Behavioural Memory Test-Third Edition (RBMT-3; Immediate Recall [RBMT-3-Im] and Delayed Recall [RBMT-3-De] tasks) and the Cognitive Failures Questionnaire (CFQ).

RESULTS

Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT-Im, and RBMT-3-Im but not on the CMT-De, RBMT-3-De, and CFQ.

CONCLUSIONS AND RELEVANCE

Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive-functional performance with immediate-memory task demands. What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive-functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.

Address: Ling-Hui Chang, PhD, is Associate Professor, Department of Occupational Therapy and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Po-Yen Chen, MS, is Occupational Therapist, Department of Occupational Therapy, Jianan Psychiatric Center, Tainan, Taiwan.; Jye Wang, PhD, is Associate Professor, Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan.; Bin-Huei Shih, MS, is Doctoral Student, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Yu-Hsuan Tseng, BS, is Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Hui-Fen Mao, MS, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; [email protected].

DOI: 10.5014/ajot.2021.041996

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MeSH Terms: Aged, Cognition, Cognitive Dysfunction, Executive Function, Female, Humans, Male, Occupational Therapy, Physical Functional Performance