Cognitive Rehabilitation and Natural Stimulations in Over 55 Years with Mild Cognitive Impairment and Hypertension

Abstract

The increasing prevalence of mild cognitive impairment (MCI) comorbid with arterial hypertension requests the revision and enhancement of available interventions. The goal of this study was to compare the effect of cognitive rehabilitation (CR) and other forms of stimulation on cognitive functions. Using a quasi-experimental design and a convenience sampling, the reception of four natural stimuli (physical and intellectual activities, hobbies, work) was collected from 128 hypertensive patients aged over 55 years with cognitive (at least two areas) and vascular impairment. Forty-four of them willingly participated in CR sessions. The effects of CR and natural stimuli on five cognitive functions were compared, three related to language (comprehensive, denominative, and fluent language), global memory and attention, assessed with the ACE Test (attention, memory, verbal fluency and language domains). Multivariate modeling analysis for repeated measures was used, controlling for potentially confounding variables. Main results show that younger age and higher academic trajectory predict better initial levels of the evaluated functions. CR is associated with gains in attention, memory and verbal fluency. Written home cognitive activities show also positive effects. The larger gains are observed in participants with higher cognitive impairment and lower academic trajectories. The postulate of the remaining cognitive reserve would synthesize these phenomena. The study concludes that CR is the preferred form of stimulation, followed by home intellectual exercises for the maintenance and partial recovery of cognitive functions in patients with mild cognitive impairment and hypertension