Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults

Working toward a theoretical model and evidence-based interventions

Marilyn Huckans, Lee Hutson, Elizabeth Twamley, Amy Jak, Jeffrey Kaye, Daniel Storzbach

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

To evaluate the efficacy of cognitive rehabilitation therapies (CRTs) for mild cognitive impairment (MCI). Our review revealed a need for evidence-based treatments for MCI and a lack of a theoretical rehabilitation model to guide the development and evaluation of these interventions. We have thus proposed a theoretical rehabilitation model of MCI that yields key intervention targets-cognitive compromise, functional compromise, neuropsychiatric symptoms, and modifiable risk and protective factors known to be associated with MCI and dementia. Our model additionally defines specific cognitive rehabilitation approaches that may directly or indirectly target key outcomes-restorative cognitive training, compensatory cognitive training, lifestyle interventions, and psychotherapeutic techniques. Fourteen randomized controlled trials met inclusion criteria and were reviewed. Studies markedly varied in terms of intervention approaches and selected outcome measures and were frequently hampered by design limitations. The bulk of the evidence suggested that CRTs can change targeted behaviors in individuals with MCI and that CRTs are associated with improvements in objective cognitive performance, but the pattern of effects on specific cognitive domains was inconsistent across studies. Other important outcomes (i.e., daily functioning, quality of life, neuropsychiatric symptom severity) were infrequently assessed across studies. Few studies evaluated long-term outcomes or the impact of CRTs on conversion rates from MCI to dementia or normal cognition. Overall, results from trials are promising but inconclusive. Additional well-designed and adequately powered trials are warranted and required before CRTs for MCI can be considered evidence-based.

Original languageEnglish (US)
Pages (from-to)63-80
Number of pages18
JournalNeuropsychology Review
Volume23
Issue number1
DOIs
StatePublished - Mar 2013

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Cognitive Therapy
Theoretical Models
Rehabilitation
Dementia
Cognitive Dysfunction
Cognition
Life Style
Randomized Controlled Trials
Quality of Life
Outcome Assessment (Health Care)

Keywords

  • Cognitive rehabilitation therapy
  • Cognitive training
  • Dementia
  • Mild cognitive impairment
  • Neuropsychological
  • Systematic review

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology

Cite this

Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults : Working toward a theoretical model and evidence-based interventions. / Huckans, Marilyn; Hutson, Lee; Twamley, Elizabeth; Jak, Amy; Kaye, Jeffrey; Storzbach, Daniel.

In: Neuropsychology Review, Vol. 23, No. 1, 03.2013, p. 63-80.

Research output: Contribution to journalArticle

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