Learning therapy for older adults with cognitive impairment: a pilot study

Abstract

Background. Studies in Japan, America and Taiwan have revealed that learning therapy, using reading aloud and arithmetic, can improve cognitive functions. The aim of the present pilot study was to investigate the effect of learning therapy on the cognitive functions and instrumental activities of daily living (IADL) performance of older adults with cognitive impairment in Hong Kong. Methods: Outpatients of the Occupational Therapy Department of our hospital who were aged ≥60 years and scored >2nd and ≤16th percentile according to ageand education-adjusted cut-off in the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) were recruited between November 2017 and March 2018. Patients were assigned to the intervention or control group. Patients in the intervention group completed 30-minute reading aloud and 30-minute arithmetic sessions daily for 8 weeks. Once per week these sessions were assisted by an occupational therapist and assistant; on other days, the tasks were self-completed. Patients in the control group received the usual care including suggested structured daily routine for 8 weeks. The primary outcome measure was change in cognitive functions as measured by HK-MoCA and the Chinese version of the Mattis Dementia Rating Scale (CDRS). Secondary outcome measure was change in score of the Hong Kong Chinese version of the Lawton IADL scale. Participants were assessed before and after intervention. Results: A total of 22 patients were assigned to the intervention group (10 women, 1 man) or the control group (8 women, 3 men). After 8 weeks, the intervention group improved significantly in terms of HKMoCA (mean change=4.4, p=0.005), specifically in the subscales of attention (mean change=1.0, p=0.04), language (mean change=2, p=0.006), abstraction (mean change=0.64, p=0.008), and delayed recall (mean change=1.55, p=0.027); CDRS (mean change=11.4, p=0.004), specifically in the subscales of attention (mean change=1.6, p=0.016), initiation/preservation (mean change=6.6, p=0.005), and memory (mean change=3.5, p=0.012); and Lawton IADL (mean change=1.0, p=0.009). In contrast, in the control group, there were no significant changes. Conclusion: The learning therapy intervention involving reading aloud and arithmetic enhanced cognitive functions and IADL performance of older adults with cognitive impairment.