Valentin Bragin, Marina Chemodanova, Gary Shereshevksy , Ilya Bragin
Stress Relief and Memory Training Center, Brooklyn, NY, USA.
Poster presentation at the 9th international Conference on Alzheimer’s Disease and Related Disorders Philadelphia, USA, July 17- 22, 2004 P1- 388
Background: Recent data demonstrates that people with early and moderated dementia may benefit from cognitive training. However, a lot of questions regarding cognitive rehabilitation of this type remain unresolved.
Objective: To investigate the possibility of computerized cognitive training combined with medication treatment in patient with moderate dementia.
Methods: Patient is a 77-year-old female, right handed, Caucasian, with 10 years of education. She presented initially in December 2001 with complaints of progressive memory decline and depression. Her medical history was remarkable for Hypertension, High Cholesterol, Coronary Artery Disease, and Hypothyroidism. Her CT scan showed mild periventricular lucency, consistent with microangiopathic ischemia. She had been taking antihypertensive medications and Synthroid, prescribed by her primary physician. In our office, she was treated with Citalopram, Galantamine, Ergoloid Mesylate, Folic Acid and Vitamin E. A battery of neuro- psychological tests (9 tests) was implemented initially after 6, 12, and 24 months of treatment. Cognitive training was on Cognometer, a software program which measures and offers feedback on brain processing speed while performing different tasks. Each of the sessions consisted of training attention and memory for 20-25 minutes.
Results: Initially, MMSE score was 21, reaction time on the physical reflexes was 534 ms, verbal fluency scores were 4 (for animals), and 2 (for letters). She showed moderate cognitive deficit in all cognitive domains, especially in executive function, attention, and visual- spatial memory. By the end of the two years, her performance on most of the tests improved with the exception of immediate visual- spatial memory and learning. MMSE score was 26, reaction time was 316 ms, verbal fluency scores were 12 (for animals) and 11 (for letters). The same positive results were replicated in the treatment of another patient.
Conclusions: For patients with moderate dementia, computerized memory training was used successfully with integrative treatment to prevent cognitive decline for two years. Improvement was most apparent on measures of cognitive speed, executive function, and visual- spatial memory. More research needs to be done, involving a greater number of patients.