Cognitive rehabilitation in dementia

Literature review: Dementia can be extremely disruptive and debilitating to everyday life leading to psychological distress. Cognitive rehabilitation is a relatively new intervention in dementia that could potentially alleviate this. The aim of the review was to critically cognitive rehabilitation in dementia. The review revealed a scarcity of research in this area with a number of methodologically limited studies. Despite their limitations the evidence for this intervention was encouraging. Further research employing more robust study designs needs to be conducted focusing on the functional, psychological and social impact of cognitive rehabilitation. Research report: To evaluate the effectiveness of a memory group providing cognitive rehabilitation a two group controlled design was used. Two matched memory clinics supplied the sample. Outcomes were activities of daily living (ADL), mood and carer strain. Memory deficit was also measured. Data was gathered at baseline and three months through a home visit by a researcher independent of the intervention. 26 intervention and 21 control participants were recruited. No statistically significant differences were found between groups at baseline. At three months deterioration in memory and ADL was observed in both groups. This was statistically significant for ADL. In the intervention group mood in participants and carers and carer strain remained stable with no statistically significant differences. In the control group statistically significant increases in participant depression, carer anxiety and depression and carer strain were observed. Effect sizes indicated a medium effect. The memory group did not have a positive effect on ADL but appeared to stabilise mood and carer strain. A possible protective effect of the group against psychological distress is a hypothesis that requires further investigation. Critical appraisal: Reflections on research process including the development for the intervention, the development of the evaluation and conducting the project are discussed.