Exploratory analysis of the influence of cognitive reserve on the benefits of cognitive stimulation therapy in patients with sporadic late-onset Alzheimer's disease
*Correspondencia: Dra. Carolina López de Luis. Facultad de Psicología. Universidad de Salamanca. Avenida de la Merced, 109-131. E-37005 Salamanca.
E-mail: caroldeluis@gmail.com
Introduction: The main objective of cognitive stimulation therapies is to promote the plasticity and learning ability that the individual is still in possession of in old age and to delay the clinical manifestations of neurodegenerative processes such as Alzheimer-type dementia. There are variables that can mediate the benefits of the intervention, such as the cognitive reserve.
Aim: To determine whether there is an interaction between the level of reserve and cognitive stimulation, and if it influences the cognitive performance of subjects with Alzheimer-type dementia.
Patients and methods: Twenty subjects (age: 66-89) with Alzheimer-type dementia who attend a day centre participated in the study. A pretest-posttest controlled design was used. The pilot group took part in the intervention for six months. Patients were classified into two levels of cognitive reserve (high and low) and then a broad neuropsychological battery was applied to perform a comprehensive analysis of cognition. Pre- and post-intervention differences were analysed through a two-factor ANOVA, one with repeated measures (pre- and post-intervention scores) and another with independent measures (level of cognitive reserve).
Results: Interaction was found in the scores on the picture arrangement subtests (WAIS-III), failure to maintain the category and the percentage of errors in the Wisconsin Card Sorting Test.
Conclusions: The positive effect of the interaction on the executive function has been observed, specifically in the capacities for planning and sequencing, perceptual organisation, response inhibition, logical reasoning and mental flexibility.
Objetivo Conocer si existe interacción entre el nivel de reserva y la estimulación cognitiva, y si influye en el rendimiento cognitivo de sujetos con demencia tipo Alzheimer.
Pacientes y métodos Participaron 20 sujetos (edad: 66-89 años) con demencia tipo Alzheimer, usuarios de un centro de día. Se utilizó un diseño pretest-postest controlado. El grupo experimental participó en la intervención durante seis meses. Se clasificó a los pacientes en dos niveles de reserva cognitiva (alta y baja) y posteriormente se aplicó una amplia batería neuropsicológica para un análisis exhaustivo de la cognición. Se analizaron las diferencias pre y postintervención a través de un ANOVA de dos factores, uno de medidas repetidas (puntuaciones pre y postintervención) y otro de medidas independientes (nivel de reserva cognitiva).
Resultados En las puntuaciones de los subtests de historietas (WAIS-III), fracasos para mantener la categoría y porcentaje de errores del test de clasificación de tarjetas de Wisconsin se encontró interacción.
Conclusiones Se ha podido observar el efecto positivo de la interacción en la función ejecutiva, concretamente en las capacidades de planificación y secuenciación, organización perceptiva, inhibición de respuesta, razonamiento lógico y flexibilidad mental.