Hétérogénéité des déficits cognitifs dans la démence de type Alzheimer et prise en charge cognitive de la mémoire: particularités et enjeux méthodologiques

[Virtual reality for clinical assessment of elderly people: early screening for dementia]

Today, there are 24.3 million people suffering from dementia worldwide, that is a new case every 7 seconds (Ferri et al., 2005) and more than 80 million cases expected in 2040. Aging-related morbidity is a real social problem making screening a major challenge. Currently, screening and diagnostic tools for dementia remain independent from each other, screening tools being non-specific and diagnostic tools non-naturalistic. With the technological possibilities offered by virtual reality, it is becoming easier to investigate cognition and behavior in elderly people. Virtual reality allows a better understanding and assessment, and perhaps could stimulate cognitive functioning of elderly people. Combining measurements of cognitive impairment and disability might help close the gap between structural and naturalistic validity.

Towards a cognitive stimulation program using an errorless learning paradigm in amnestic mild cognitive impairment

Considering the high risk for amnestic mild cognitive impairment (A-MCI) individuals to progress towards dementia, it is crucial to study the efficacy of innovative treatment strategies such as cognitive stimulation techniques. The present study is a case report of two individuals presenting with A-MCI who were enrolled in a memory training program. After a broad neuropsychological assessment, the two participants were trained with an errorless (EL) learning paradigm on an individual basis, twice a week, over three weeks. Two follow-up sessions took place one and five weeks after the end of the training. Results showed that the program was well tolerated and feasible, and enhanced daily memory abilities. For the second participant only, a re-evaluation of her cognitive profile was completed 23 months after her first assessment and training. In addition, EL was directly compared with a control condition using an errorful (EF) learning paradigm to teach her new names over two sessions (one session for each condition). Her improvement on the trained material supported the preliminary efficacy of EL compared with EF for learning episodic material. These results are compatible with previous work that has preliminarily demonstrated the efficacy of an EL paradigm in patients with dementia.