Errorless Learning and Spaced Retrieval Training for Clients with Alzheimer's Dementia

[Trouble neurocognitif majeur et méthodes optimisant l'apprentissage]

Les difficultés cognitives consécutives aux troubles neurocognitifs majeurs (TNCM) engendrent des enjeux dans la réalisation d'activités de la vie quotidienne. Ce projet visait à identifier auprès des proches aidants et des intervenants des situations nécessitant des méthodes optimisant l'apprentissage pour faciliter l'engagement de personnes vivant avec un TNCM dans leurs activités de la vie quotidienne. Des entrevues individuelles semi-dirigées, d'une durée de 60 à 90 minutes, ont été menées auprès de proches aidants et d'intervenants. Les résultats montrent que les activités quotidiennes et domestiques sont notamment affectées par les difficultés à repérer ou à utiliser les objets, à garder en tête la tâche en cours, à mettre en séquences des étapes, à ne pas se laisser distraire par autre chose et à constater ses difficultés pour s'y adapter. Les proches aidants souhaitent du soutien dans l'application des méthodes optimisant l'apprentissage pour contribuer au maintien de l'autonomie des personnes vivant avec un TNCM.

A Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risks in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study

BACKGROUND

The association between gait and cognition, and their combined impact on postural stability may underlie the increased fall risk in older adults with dementia. However, there are few interventions to improve functional mobility and reduce fall risks in people with cognitive impairment.

OBJECTIVES

This study aims to investigate the feasibility and acceptability of a Safe Mobilisation Program for cognitively impaired older adults with higher level gait disorders. It also explores the potential effectiveness of the program on mobility and fall risks.

METHODS

Fifteen community-dwelling older adults participated in a 3-week pre-post intervention study. They were trained to take steady steps in transfers and mobilization using errorless learning and spaced retrieval teaching techniques.

RESULTS

The intervention program was feasible, all the participants completed the program and were able to mobilize safely. The program was acceptable and participants reported an increase in safety awareness, improvement in confidence while transferring and mobilising, and better quality of life. There was a trend of improvement in Falls Efficacy Scale-international (FES-I), 360° turn and Tinetti Performance Oriented Mobility Assessment (POMA), which may indicate improvement in balance and mobility.

CONCLUSION

The Safe Mobilisation Program was feasible and acceptable in older adults with cognitive impairment and gait disorders and warrants further evaluation.

Spaced Retrieval and Episodic Memory Training in Alzheimer's Disease

Introduction

This study replicated and extended the findings from the author's previous pilot study to further explore how a spaced retrieval (SR) memory training program might be effectively applied to help persons with Alzheimer’s disease (AD)  improve both short- and long-term recall of recent episodic events.

Methods

A quasi-experimental within-subject group study was conducted with 15 participants with a diagnosis of AD.

Results

Compared to a control condition, all participants were able to spontaneously recall significantly more specific details about trained events, and their recall was significantly enhanced when they were provided with cues. Although the findings indicated that people with AD were able to encode information during training, recall gains diminished by the end of the maintenance period.

Discussion

This study provides evidence that individuals with mild to moderate AD can learn and recall new episodic information through SR training. These findings support the use of SR as an intervention tool to help individuals maintain their functioning in episodic recent memory. However, more research into maintaining the long-term recall of recent episodic events is warranted.

Effects of spaced retrieval training with errorless learning in the rehabilitation of patients with dementia

[Purpose] Among the non-pharmacological interventions for dementia, spaced retrieval training (SRT) is a good method for rehabilitating cognition. The purpose of this study was to examine effects of SRT with errorless learning (EL) in the rehabilitation of patients with dementia. [Subjects and Methods] Twenty-nine participants with vascular dementia (VD) and Alzheimer’s disease (AD) participated in the present study. The Korean version of the Consortium to Establish a Registry for Alzheimer’s disease (CERAD-K) and Modified Barthel Index (MBI) were performed to assess the changes in the neuropsychological performance and the independent activities of daily living after SRT with EL. All tests were administered both before and after SRT with EL. Each SRT with EL intervention was performed for 30 minutes per day for 5 weeks. SPSS for Windows version 18.0 was used for statistical analysis. [Results] All items of the CERAD-K score of the VD group except for constructional praxis increased significantly after the SRT with EL intervention, but no significant differences from the AD group were found. The Korean version of the geriatric depression scale (GDS-K) of the VD group increased significantly after the SRT with EL intervention. The mean MBI scores of each group showed no significant difference after the intervention. [Conclusion] SRT with EL is an effective intervention for memory training of patients with dementia. Future research using sufficient sample sizes will be needed to obtain strong evidence for comparing not only the before and after intervention data but also between the groups.