Background: The evolution of dementia depends on the underlying pathology, early diagnosis and the availability of effective treatment for some of the symptoms that interfere with the patients' or caregivers' quality of life. Even though there is no specific treatment to reverse dementia, some interventions such as reality orientation and skills training can retard cognitive impairment. Aim: To review existing scientific evidence regarding the efficacy of therapies included in the category of cognition-oriented approaches for people suffering from dementia. Methods: Papers were retrieved from several bibliographic databases (last publication date: 2009) with pre-specified selection criteria, data extraction and methodological quality assessment. Results: Nine reality orientation and 8 skills training trials were identified as meeting the inclusion criteria. Conclusions: Stimulation of cognitive functions, especially by means of reality orientation, improves overall cognitive function in patients suffering from dementia.

Keywords:
Dementia, Cognition-oriented therapies, Reality orientation, Skills training, Systematic review
1.
Bierman EJ, Comijs HC, Jonker C, Beekman AT: Symptoms of anxiety and depression in the course of cognitive decline. Dement Geriatr Cogn Disord 2007;24:213-219.
2.
Wimo A, Winblad B, Aguero‐Torres H, von Strauss E: The magnitude of dementia occurrence in the world. Alzheimer Dis Assoc Disord 2003;17:63-67.
3.
Aalten P, Verhey FRJ, Boziki M, Brugnolo A, Bullock R, Byrne EJ, et al: Consistency of neuropsychiatric syndromes across dementias: results from the European Alzheimer Disease Consortium. Part II. Dement Geriatr Cogn Disord 2008;25:1-8.
4.
Brookmeyer F, Johnson E, Ziegler-Graham K, Arrighi HM: Forecasting the global burden of Alzheimer's disease. Alzheimers Dement 2007;3:186-191.
5.
Graham JE, Mitnitski AB, Mogilner AJ, Gauvreau D, Rockwood K: Symptoms and signs in dementia synergy and antagonism. Dement Geriatr Cogn Disord 1996;7:331-335.
6.
Aymerich M, Guillamón I, Jovell AJ: Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe). Patient Prefer Adherence 2009;3:311-321.
7.
Markowitz JS, Gutterman EM, Sadik K, Papadopoulos G: Health-related quality of life for caregivers of patients with Alzheimer disease. Alzheimer Dis Assoc Disord 2003;17:209-214.
8.
American Psychiatric Association: Practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Arlington, American Psychiatric Association, 2007.
9.
Scottish Intecollegiate Guidelines Network (SIGN): SIGN 50: a guideline developer's handbook. http://www.sign.ac.uk/guidelines/fulltext/50/index.html. Edinburgh, Scottish Intercollegiate Guidelines Network, 2008.
10.
Taulbee LR, Folsom JC: Reality orientation for geriatric patients. Hosp Community Psychiatry 1966;17:133-135.
11.
Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, et al: Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. Br J Psychiatry 2003;183:248-254.
12.
Spector A, Orrell M, Davies S, Woods B: Can reality orientation be rehabilitated? Development and piloting of an evidence-based programme of cognition-based therapies for people with dementia. Neuropsychol Rehabil 2001;11:377-397.
13.
Onder G, Zanetti O, Giacobini E, Frisoni GB, Bartorelli L, Carbone G, et al: Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial. Br J Psychiatry 2005;187:450-455.
14.
Baldelli MV, Pirani A, Motta M, Abati E, Mariani E, Manzi V: Effects of reality orientation therapy on elderly patients in the community. Arch Gerontol Geriatr 1993;17:211-218.
15.
Wallis GG, Baldwin M, Higginbotham P: Reality orientation therapy - a controlled trial. Br J Med Psychol 1983;56:271-277.
16.
Woods RT: Reality orientation and staff attention: a controlled study. Br J Psychiatry 1979;134:502-507.
17.
Breuil V, de Rotrou J, Forette F, Tortrat D, Ganansia-Ganem A, Frambourt A, et al: Cognitive stimulation of patients with dementia: preliminary results. Int J Geriatr Psychiatry 1994;9:211-217.
18.
Gerber GJ, Prince PN, Snider HG, Atchison K, Dubois L, Kilgour JA: Group activity and cognitive improvement among patients with Alzheimer's disease. Hosp Community Psychiatry 1991;42:843-845.
19.
Baines S, Saxby P, Ehlert K: Reality orientation and reminiscence therapy. A controlled cross-over study of elderly confused people. Br J Psychiatry 1987;151:222-231.
20.
Galante E, Venturini G, Fiaccadori C: Computer-based cognitive intervention for dementia: preliminary results of a randomized clinical trial. G Ital Med Lav Ergon 2007;29(suppl 3):B26-B32.
21.
Loewenstein DA, Acevedo A, Czaja SJ, Duara R: Cognitive rehabilitation of mildly impaired Alzheimer disease patients on cholinesterase inhibitors. Am J Geriatr Psychiatry 2004;12:395-402.
22.
Cahn-Weiner DA, Malloy PF, Rebok GW, Ott BR: Results of a randomized placebo-controlled study of memory training for mildly impaired Alzheimer's disease patients. Appl Neuropsychol 2003;10:215-223.
23.
Davis RN, Massman PJ, Doody RS: Cognitive intervention in Alzheimer disease: a randomized placebo-controlled study. Alzheimer Dis Assoc Disord 2001;15:1-9.
24.
Quayhagen MP, Quayhagen M, Corbeil RR, Roth PA, Rodgers JA: A dyadic remediation program for care recipients with dementia. Nurs Res 1995;44:153-159.
25.
Tappen RM: The effect of skill training on functional abilities of nursing home residents with dementia. Res Nurs Health 1994;17:159-165.
26.
Heiss WD, Kessler J, Mielke R, Szelies B, Herholz K: Long-term effects of phosphatidylserine, pyritinol, and cognitive training in Alzheimer's disease. A neuropsychological, EEG, and PET investigation. Dementia 1994;5:88-98.
27.
Rosswurm MA: Attention-focusing program for persons with dementia. Clin Gerontol 1991;10:3-16.
28.
Doody RS, Stevens JC, Beck C, Dubinsky RM, Kaye JA, Gwyther L, et al: Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56:1154-1166.
29.
Spector A, Davies S, Woods B, Orrell M: Reality orientation for dementia: a systematic review of the evidence of effectiveness from randomized controlled trials. Gerontologist 2000;40:206-212.
30.
Woods B, Aguirre E, Spector A, Orrell M: Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012:CD005562.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.