Jacqueline Abrisqueta-Gomez

Recognition memory for emotional pictures in Alzheimer's patients

Objective– The purpose of the present study was to examine whether Alzheimer’s Disease (AD) patients can benefit from the emotional content of visual stimuli in a picture recognition test. Method– Sixteen patients with AD and 19 normal controls matched for age and years of education, were studied. Sixteen pictures (with varying emotional contents) were presented to each participant. Thirty minutes later, a recognition test was applied with the target‐pictures mixed among 34 others of similar content. The subjects were instructed to rate them as pleasant, unpleasant or indifferent. Results– The total of pictures correctly recognized by the AD patients (75.4% of the target‐pictures) was smaller than that of the controls (96.4%). Controls recognized more emotional pictures than indifferent pictures. Conclusions– Emotional content enhanced recognition of pictures in normal subjects, whereas for the Alzheimer’s subjects the emotional significance attached to the pictures was of no benefit to enhance recognition.

A longitudinal study of a neuropsychological rehabilitation program in Alzheimer's disease

UNLABELLED Our aim was to study the duration of benefits derived from a neuropsychological rehabilitation program (NRP) for dementia patients. METHOD The participants in this study were three patients diagnosed as probable Alzheimers disease in the initial-to-moderate phase; the three were taking anticholinesterases. They were submitted to a neuropsychological evaluation (NE) before the NRP and then reevaluated after 12 and 24 months of treatment. The aim of our intervention was to do practical work with implicit and explicit residual memory by training them in everyday life activities, and using compensatory strategies and their intact cognitive abilities. RESULTS Analysis of quantitative NE data (descriptive measures) after the first year of NRP showed cognitive improvement, functional stabilization and fewer behavioral problems. However, this improvement did not continue in the second year, and the disease maintained its characteristic progression.

Applicability of the abbreviated neuropsychologic battery (NEUROPSI) in Alzheimer disease patients.

NEUROPSI is a brief neuropsychologic battery developed to briefly assess a wide spectrum of cognitive functions. The aim of this study was to examine the applicability of a Portuguese version of this battery and verify the efficacy in detecting cognitive impairment in Alzheimer disease (AD) patients. NEUROPSI was applied to 75 elderly people, 25 patients with probable AD in mild stage (AD1), 25 patients in moderate stage (AD2), and 25 healthy elderly persons (control group), matched with the AD patients for age and schooling. Before testing all participants were applied the Mini-Mental State Examination. Results showed significant differences in total scores of the tests; NEUROPSI (P<0.001) and Mini-Mental State Examination (P<0.001), and the control group scored highest in both of the tests followed by groups AD1 and AD2. Differences were also found between the initial phase and the moderate phase. Results indicate that NEUROPSI is an efficient instrument for detecting AD patients in the initial stage of the disease.

EFFECTS OF SEMANTIC RELATIONS, REPETITION OF WORDS, AND LIST LENGTH IN WORD LIST RECALL OF ALZHEIMER'S PATIENTS

INTRODUCTION Semantic relations among words and repetition enhance free recall, but it is unknown if these facilitating factors are effective in dementia. METHOD Alzheimers patients (MILD-Alz, MOD-Alz) were compared to healthy elderly. Fifteen-word lists were read out to the subjects. In four sets of lists the words in intermediary input positions were semantically related or not, or the midlist words were repeated, or they were repeated and semantically related. RESULTS The usual third peak of recall of semantically related words was not observed in MOD-Alz, repetition of words did not increase recall of the patients, and the combination of relatedness and repetition benefited only MID-Alz. In a second experiment, with related or unrelated midlist words, and list length shortened from 15 to 9 words, semantic facilitation was observed in mild and moderate Alzheimer s patients, although diminished compared to controls. CONCLUSION Progression of dementia turns facilitating factors of recall less effective.

Neuropsychological rehabilitation program and behavioral disturbances in early-stage Alzheimer patients

Alzheimer’s disease (AD) is the most frequent cause of dementia and cholinesterase inhibitors are the available treatment in the mild stage. However cognitive rehabilitation has shown satisfactory results when combined with pharmacological treatment. Behavioral alteration is common in AD patients, which burdens caregivers and raises the risk of institutionalization. Providing caregivers guidance may enable them to assure better quality of life for patient and caregiver and lower institutionalization rates. Objective To evaluate the effects of a neuropsychological rehabilitation program (NRP) combined with pharmacological treatment in early stage AD patients. Methods We studied 12 AD patients (6 women), average age 75.42 (6.22) with 9.58 (5.6) years education in use of stable doses of cholinesterase inhibitors. Cognitive performance was evaluated using Mini-Mental State Examination (MMSE) and Alzheimer´s Disease Assessment Scale-cognitive (ADAS-Cog). Caregivers responded to Neuropsychiatric Inventory (NPI) and Functional Activities Questionnaire (FAQ) at initial evaluation (T1), and after 8 months of rehabilitation program (T2). The program comprised two sessions every week and family guidance every fortnight. Results MMSE (T1:23.25 (1.82)/T2:23.42 (2.81); ADAS-Cog (T1:17.11 (6.73)/T2:21.2 (8.59); NPI (T1:23.42 (23.38)/T2:19.83 (17.73); FAQ (T1:10.67 (7.24)/T2: 13.92 (6.92). Conclusions These results show the importance of providing guidance and support for caretakers. Study limitations were the small number of patients and absence of a control group with only drug treatment to compare with combined pharmacological and rehabilitation treatments.

P-091: Assessment of behavior and mood problems in Alzheimer patients

Background: The benefits of behavioral interventions for improving the functioning of AD patients have increasingly been explored. The methods of behavior assessment used will help the family and caregivers to recognize and to manage routine problems. Objective(s): Assess the impact of behavioral and mood alterations in mild to moderate phase Alzheimer’s disease patients. Methods: Subjects were 24 probable-AD patients in initial to moderate phase, average age 73.4 (6.8) and average schooling 9.5 (5.4). All were using cholinesterase inhibitors and were submitted to Neuropsychological Testing (NT) using the following instruments: Abbreviated Neuropsychological Battery (NEUROPSI), Mini Mental State Exam (MMSE), and Functional Performance Scale. The Revised Memory and Behavior Problem Checklist (RMBPC) was used to assess the frequency of memory problems (MP), mood alterations (MA), disruptive behavior (DB) in the patients’ everyday life and the caregiver’s reaction to these problems. Results: When we analyzed the three domains assessed on the scale RMPC, we noted predominance in the frequency of MP (68%) followed by MA (24%) and DB (8%). On the other hand, the caregivers’ negative responses to the problems were in MP (50%), followed by MA (34%), and DB (16%). The DB was more stressful for the caregivers. Conclusions: According to the observations in this study the memory problems are predominantly in the patients with Alzheimer’s disease. However, what is mostly stressing the families is the disruptive behavior that starts to appear in the initial phase of the disease. Future interventions should be directed to treat this problem.