Cognitive Rehabilitation Improves Dementia Patients’ Goal Attainment, Study Shows

Goal-oriented cognitive rehabilitation was better than standard treatment or relaxation therapy at helping dementia patients achieve goals, a study reported.

It also led to patients getting more satisfaction from attaining goals, researchers said. And it led to caregivers reporting less stress and a better quality of life. The study was based on patients’ and caregivers’ self-reports.

The types of dementia the patients had were associated either with Parkinson’s disease or Lewy bodies, researchers said.

Their study, “Goal-orientated cognitive rehabilitation for dementias associated with Parkinson’s disease―A pilot randomised controlled trial,” appeared in the International Journal of Geriatric Psychiatry.

The main objective of the study was to assess the appropriateness and feasibility of goal-oriented cognitive rehabilitation for people with Parkinson’s-related dementia.

In goal-oriented cognitive rehabilitation, people with dementia and their families work together with a health professional to identify needs and goals, then try to achieve the goals.

The study included 29 people with dementia associated with Parkinson’s or with Lewy bodies and 26 caregivers.  After the patients set goals, they were randomized into three groups.

Ten received goal-focused cognitive rehabilitation, 10 others relaxation therapy, and nine standard treatment.

Cognitive rehabilitation occurred in eight weekly one-hour sessions with a therapist. Participants were given strategies for overcoming difficulties in planning and retaining information.

Relaxation therapy, also given in one-hour sessions for eight weeks, taught participants muscle relaxation and breathing exercises.

Participants in both groups were encouraged to practice their strategies between sessions with the help of their caregivers.

The study’s primary objective was to see if goal-oriented cognitive rehabilitation could improve patients’ ability to achieve goals and their satisfaction attaining goals than standard treatment.

One set of secondary objectives involved patients and another set caregivers. The patient set included seeing whether cognitive rehabilitation could improve patients’ mood, cognition, overall health, quality of life, and daily functioning. The caregiver set included seeing whether patients’ cognitive rehabilitation could reduce caregivers’ stress and improve their quality of life.

Researchers received patient and caregiver assessments at two and six months after the start of the study.

Two months after the patients set goals, the cognitive rehabilitation group reported more success achieving goals and more satisfaction doing so than the other groups. Another finding was that the relaxation therapy group reported better goal-attainment success and satisfaction than those in the standard treatment group.

At six months, cognitive rehabilitation continued to outperform standard treatment and relaxation therapy, although the difference was not as great as at two months.

Patients’ ability to achieve secondary objectives varied between the two-month and six-month assessments. At two months, cognitive rehabilitation did a better job than standard treatment and relaxation therapy in maintaining or improving patients’ mood and self-efficacy, or the feeling they could  achieve a goal. Those caring for cognitive rehabilitation patients reported that the quality of their own life had improved.

At six months, cognitive rehabilitation patients reported less delay in recalling information, better overall health, and better quality of life. Those caring for cognitive rehabilitation patients reported less stress, better overall health, and better quality of life than those caring for patients receiving standard treatment.

The results prompted researchers to suggest that goal-oriented cognitive rehabilitation is an effective treatment for dementia associated with Parkinson’s.

“Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson’s disease,” they wrote.