Cognitive rehabilitation and cognitive training for mild dementia

Abstract

Cognitive deficits caused by dementing illnesses are chronic and progressive problems, which should be tackled both by biological and non-biological approaches. Among the various techniques of non-biological approaches (cognitive rehabilitation), centered is cognitive training intervention for individuals with dementia. Cognitive training is further divided into two different types of setting: Group and individualized. Among group training techniques, the reality orientation training and day care/day services are known to have evidence-based efficacy. Individually tailored cognitive training aims to directly and explicitly improve cognitive functioning of people with dementia specifically in the early stages. Increasing evidence demonstrates the efficacy of various individualized training programs for dementia, including Alzheimer's disease (AD). Specifically, three techniques, known as spaced retrieval, dual cognitive support and procedural memory training, have shown promise in their ability to enhance learning in people with dementia. In addition, recent studies have suggested that a combination of pharmacotherapy and cognitive training may benefit individuals with AD. Cognitive training appears to be particularly effective for people with mild memory impairment who are on cholinergic treatment. It is now widely accepted that the theoretical framework of 'errorless learning' is also a guiding principle in the realm of cognitive training for people with dementia. Although the effect of factors, namely effort (effortful vs effortless) and stimulus features (perceptual vs conceptual), has not been fully determined, error elimination during learning sessions is essential for favorable outcomes. © 2007 The Authors; Journal compilation © 2007 Japanese Psychogeriatric Society.