Use of a Memory Gym Intervention as a Post-diagnostic

Support in the Management of Mild Cognitive Impairment.

1
OCaoimh ,

2
Sato ,

3
Wall ,

2
ORegan ,

Rnn
Stephen
Judy
Louise M
Mary J Foley4, Suzanne Timmons1, D. William Molloy1
1 Centre

for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland.
2 Department of Occupational Therapy, St Finbarrs Hospital, Douglas Road, Cork City, Ireland.
3 Department of Clinical Psychology, Le Chile, St Finbarr's Hospital, Douglas Road, Cork City, Ireland.
4 Assessment and Treatment Centre, St Finbarrs Hospital, Cork City, Ireland.

Introduction

Results

Pharmacological treatment options for people with mild cognitive

impairment (MCI) and early dementia are limited.

In all, 14 completed the gym intervention in two groups.

Lifestyle interventions may delay conversion of MCI to dementia.

-
-
-
-

These include:
Cognitive interventions Brain Training & compensatory techniques.
Diet & exercise.
Stress management & mindfulness.
Art therapy.

Few studies have investigated the effect of a formal suite or gym of

cognitive and lifestyle modification and educational strategies, providing
post diagnostic support, in preventing or delaying this conversion.

The median age of participants (cases) was 72 (interquartile of +/-6) years

compared to 76 (+/-11) years for non participants (control group) (n=20).
No significant difference in baseline age, gender, years in education, duration of
follow-up & SMMSE, Qmci and Caregiver scores.
Significant difference in median 6 month rate of change in Qmci scores for those
with MCI only, +0.4/100 versus -3.5/100, p=0.024, (see Figure 1).
User feedback was positive, with most patients satisfied with the educational
suite of assessments.
Group
Number
Follow-up in months (Median & IQR)
Age (Median & IQR)
Gender (% female)
Education in years (Median & IQR)
Diagnosis
-MCI
-Early dementia
SMMSE (Median & IQR)
Qmci (Median & IQR)
Caregiver scores (Median & IQR)
SMMSE (Median & IQR)
Qmci scores (Median & IQR)
Qmci scores (MCI only)
Caregiver Burden Scores
(Median & IQR)
Percentage with diagnosis

Methods
Case-control study.
Comparing a six-week memory-gym group-therapy programme to
usual care.
Consecutive patients diagnosed with either MCI or early dementia.
Single university hospital memory clinic.
Patients were included only if baseline and end-point (standardised at 6
months apart) scores were available for the following:
-Standardised Mini-Mental State Examination (SMMSE) [score 0-30],
-Quick Mild cognitive Impairment (Qmci) screen [score 0-100],
-Caregiver Scores (Modified Zarit), [score 0-30]
One six-week programme with one booster session at three months
with Facebook support.

Participants
Dementia

Mild Cognitive
Impairment
Excluded
Analysis

Diagnosed clinically by a consultant geriatrician after full

work-up for alternative causes, based upon DSM-IV criteria.
Severity correlated to Reisberg FAST scale
Depression excluded clinically supported by Geriatric
Depression Scale (GDS) score 7.
Diagnosed clinically if
1.Subjective & corroborated memory loss
2.No obvious loss of function
3.Objective impairment in memory tests
Subjects with Lewy body dementia or Parkinsons disease.
Depression excluded clinically (supported by GDS score).
Aged < 45 years & if English was not their first language.
All data were non parametric. Medians were compared with
Mann-Whitney U test. Chi-Squared tests compared
distributions. Six month rate of decline was measured
according to this formula: Rate of decline = (Baseline score
End-point score) x 6/ Duration in months.

P=0.58

Participants

Non Participants

(Cases)

(Controls)

P=X

14
18 (+/-5)
72 (+/-6)
71%
14 (+/-3)

-13
-1
29 (+/-4)
59.5 (+/- 15)
2 (+/-5)
-0.66 (+/-0.9)
-0.13 (+/- 2.9)
0.4 (+/- 2.9)
0 (+/- 0.4)

20
18.5 (+/-7.75)
76 (+/-11)
70%
12 (+/-6)

-7
-3
28.5 (+/-3)
56 (+/-11)
6 (+/- 11)
-0.39 (+/- 1.1)
-3.08 (+/- 5.5)
-3.5 (+/-5.5 )
0 (+/-4.6 )

-
0.72
0.26
1.0
0.71
-

14% (2/14)

40% (8/20)

0.14

P=0.057

0.51
0.98
0.41
0.58
0.057
0.024
0.55

P=0.024

Figure 1. Comparison of median six month rates of decline in SMMSE, Qmci scores and Qmci
scores in those with MCI only between participants (cases) and non-participants (controls).

Conclusion
In this pilot study we found a significant change in median 6 month rate of
decline in Qmci cognitive scores despite no difference in caregiver scores.
Only 14% of cases converted from MCI to dementia, less than half of those in
the control group.
Confounding by indication may have lead to bias.
A suite of interventions including cognitive training called a memory Gym may
help slow rate of decline in those with MCI.
Most participants enjoyed the sessions and would participate again.