Eficacia del entrenamiento cognitivo basado en nuevas tecnologías en pacientes con demencia tipo Alzheimer

  1. Fernández Calvo, Bernardino
  2. Rodríguez Pérez, Roberto
  3. Contador, Israel
  4. Rubio Santorum, Alicia
  5. Ramos Campos, Francisco
Revista:
Psicothema

ISSN: 0214-9915

Año de publicación: 2011

Volumen: 23

Número: 1

Páginas: 44-50

Tipo: Artículo

Otras publicaciones en: Psicothema

Resumen

El estudio pretende evaluar la efi cacia del �Big Brain Academy� (BBA), un programa de entrenamiento cognitivo (EC) computarizado basado en un videojuego, frente al Programa de Psicoestimulación Integral (PPI), un instrumento típico de EC, en pacientes con Enfermedad de Alzheimer (EA). Un total de 45 pacientes con EA, en fase leve, fueron asignados de manera aleatoria a tres condiciones experimentales. Se establecieron dos grupos de tratamiento, donde los pacientes recibieron o bien un programa de estimulación con BBA (EABB), o bien un programa estimulación tradicional (EAPI), basado en tareas de papel y lápiz, durante doce semanas. Un tercer grupo, que no recibió ningún tratamiento durante este período, se le asignó la condición de grupo control (EANT). La efi cacia diferencial de los programas se evaluó mediante un diseño pre-post, a través de medidas neuropsicológicas, conductuales y funcionales estandarizadas. El grupo EABB mostró un declive cognitivo signifi cativamente más lento en comparación a los grupos EAPI y EANT. Además, el grupo EABB manifestó una reducción de la sintomatología depresiva signifi cativamente mayor en relación a los grupos EAPI y EANT. El BBA fue más efectivo que el PPI para reducir el declive cognitivo y los síntomas depresivos en los pacientes con EA.

Referencias bibliográficas

  • Alexopoulus, G.S., Abrams, R.C., Young, R.C., y Shamoian, C.A. (1988). Cornell scale for depresion in dementia. Biological Psychiatry, 23, 271-284.
  • Bäckman, L. (1996). Utilizing compensatory task conditions for episodic memory in Alzheimer's disease. Acta Neurologica Scandinavia, 165, 109-113.
  • Baldelli, M.V., Pirani, A., Motta, M., Abati, E., Mariano, E., y Manzi, V. (1993). Effects of reality orientation therapy on patients in the community. Archives of Gerontology and Geriatrics, 17, 211-218.
  • Boada, M., Cejudo, J.C., Tárraga, L., López, O.L., y Kaufer, D. (2002). Neuropsychiatric Inventory Questionnaire (NPI-Q): validación española de una forma abreviada del Neuropsychiatric Inventory (NPI). Neurología, 17, 317-323.
  • Bottino, C.M., Carvalho, I.A., Álvarez, A.M.M., Ávila, R., Zukauskas, P.R., Bustamante, S.E., Andrade, F.C., Hototian, S.R., Saffi, F., y Câmargo, C.H. (2005). Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: A pilot study. Clinical Rehabilitation, 19, 861-869.
  • Chapman, S.B., Weiner, M.F., Rackley, A., Hynan, L.S., y Zientz, J. (2004). Effects of cognitive-communication stimulation for Alzheimer's disease patients treated with donepezil. Journal of Speech, Language and Hearing Research, 47, 1149-1163.
  • Clare, L. (2008). Introducing neuropsychological rehabilitation and people with dementia. En L. Clare (Ed.), Neuropsychological Rehabilitation and People with Dementia (pp. 1-4). Hove: Psychology Press.
  • Clare, L., y Woods, B (2003). Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. En The Cochrane Library, Issue 4. Chichester, UK: John Wiley & Sons Ltd.
  • Clare, L., Woods, R.T., Moniz-Cook, E.D., Orrell, M., y Spector, A. (2003). Cognitive rehabilitation and cognitive training interventions targeting memory functioning in early stage Alzheimer's disease and vascular dementia (Cochrane Review). En The Cochrane Library, Issue 4. Chichester, UK: John Wiley & Sons Ltd.
  • Cohen, G.D., Firth, K.M., Biddle, S., Lloyd, M.J., y Simmens, S. (2009). The first therapeutic game specifically designed and evaluated for Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 23, 540-551.
  • Diller, L. (1976). A model for cognitive retraining in rehabilitation. The Clinical Psychologist, 29, 13-15.
  • Farina, E., Fioravanti, R., Chiavari, L., Imbornone, E., Alberoni, M., Pomati, S., Pinardi, G., Pignatti, R., y Mariani, C. (2002). Comparing two programs of cognitive training in Alzheimer's disease: A pilot study. Acta Neurologica Scandinavica, 105, 365-371.
  • Farina, E., Mantovani, F., Fioravanti, R., Rotella, G., Villanelli, F., Imbornone, E., Olivotto, F., Tincani, M., Alberoni, M., Petrone, E., Nemni, R., y Postiglione, A (2006). Efficacy of recreational and occupational activities associated to psychologic support in mild to moderate Alzheimer disease: A multicenter controlled study. Alzheimer Disease and Associated Disorders 20, 275-282.
  • Folstein, M.F., Folstein, S.E., y McHugh, P.R. (1975). Mini-Mental State: A practical method for grading the state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.
  • Forstmeier, S., y Maercker, A. (2008). Motivational reserve: Lifetime motivational abilities contribute to cognitive and emotional health in old age. Psychology and Aging, 23, 886-899.
  • Gatz, M., Fiske, A., Fox, L.S., Kaskie, B., Kasl-Godley, J.E., McCallum, T.J., y Wetherell, J.L. (1998). Empirically validated psychological treatments for older adults. Journal of Mental Health and Aging, 4, 9-46.
  • Goodman, C.R., y Zarit, S.H. (1995). Ecological measures of cognitive functioning: A validation study. International Psychogeriatry, 7, 39-50.
  • Hofmann, M., Hock, C., Kuhler A., y Muller-Spahn, F. (1996). Interactive computer-based cognitive training in patients with Alzheimer's disease. Journal of Psychiatric Research, 30, 493-501.
  • Hughes, C.P., Berg, L., Danziger, W.L., Cohen, L.A., y Martin, R.L.(1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566-572.
  • Karlsson, I., Brane, G., Melin, E., Nyth, A.I., y Rybo, E. (1988). Effects of environmental stimulation on biochemical and psychological variables in dementia. Acta Psychiatrica. Scandinavica, 77, 207-213.
  • Linn, M.W., y Linn, B.S. (1982). The rapid disability rating Scale-2. Journal of the American Geriatrics Society, 30, 378-382.
  • Loewenstein, D.A., Acevedo, A., Czaja, S.J., y Duara, R. (2004). Cognitive rehabilitation of mildly impaired Alzheimer disease patients on cholinesterase inhibitors. American Journal of Geriatric Psychiatry, 12, 395-402.
  • Luria, A.R. (1966). Human brain and Psychological processes. New York: Harper & Row.
  • McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., y Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services task force on Alzheimer's disease. Neurology, 34, 939-944.
  • Mobs, R.C., Rosen, W.G., y Davis, K.L. (1983). The Alzheimer's Disease Assessment Scale: An instrument for assessing treatment efficacy. Psychopharmacological Bulletin, 19, 448-450.
  • Olazarán, J., Muñiz, R., Reisberg, B., Peña-Casanova, J., del Ser, T., Cruz-Jentoft, A.J., Serrano, P., Navarro, E., García de la Rocha, M.L., Frank, A., Galiano, M., Fernández-Bullido, Y., Serra, J.A., González-Salvador, M.T., y Sevilla, C. (2004). Benefits of cognitive motor intervention in MCI and mild to moderate Alzheimer's disease. Neurology, 63, 2348-2353.
  • Ragneskog, H., Kihlgren, M., Karlsson, I., y Norberg, A. (1996). Dinner music for demented patients: Analysis of video-recorded observations. Clinical Nursing Research, 5, 262-282.
  • Requena, C., Maestu, F., Campo, P., Fernández, A., y Ortiz, T. (2006). Effects of cholinergic drugs and cognitive training on dementia: 2-year follow-up. Dementia and Geriatric Cognitive Disorders, 22, 339-345.
  • Schreiber, M., Schweizer, A., Lutz, K., Kalveram, K.T., y Jancke, L. (1999). Potential of an interactive computer based training in the rehabilitation of dementia: An initial study. Neuropsychological Rehabilitation, 9, 155-167.
  • Sitzer, D.I., Twamley, E.W., y Jeste, D.V. (2006). Cognitive training in Alzheimer's disease: A meta-analysis of the literature. Acta Psychiatrica Scandinavica, 114, 75-80.
  • Small, G., Rabins, V., Barry, P., Buckholtz, N., Dkosky, S., Ferris, S. Finkel, S.I., Gwyther, L.P., Khachaturian, ZS., Lebowitz, B.D., McRae, T.D., Morris, J.C., Oakley, F., Schneider, L.S., Streim, J.E., Sunderland, T., Teri L.A., y Tune L.E. (1997). Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. JAMA, 278, 1363-1371.
  • Spector, A., Thorgrimsen, L., Woods, R.T., Royan, L., Davies, S., Butterworth, M., y Orrell, M. (2003). Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia. British Journal of Psychiatry, 183, 248-254.
  • Tárraga, L. (1998). Terapias blandas: Programa de Psicoestimulación Integral. Alternativa terapéutica para las personas con enfermedad de Alzheimer. Revista de Neurología, 27, 51-62.
  • Tárraga, L., Boada, M., Modinos, G., Badenas, S., Espinosa, A., Diego, S., Morera, A., Guitart, M., Balcells, J., López, O.L., y Becker, J.T. (2006). «A randomized pilot study to assess the efficacy of Smartbrain®, an interactive, multimedia tool of cognitive stimulation in Alzheimer's disease». Journal of Neurology, Neurosurgery and Psychiatry, 77, 1116-1121.
  • Wilson, B.A. (1997). Cognitive rehabilitation: How it is and how it might be. Journal of the International Neuropsychological Society, 3, 487-496.
  • Woods, R.T. (2003). Non-pharmacological techniques. En N. Qizilbash, L.S. Schneider, H. Chui, P. Tariot, H. Brodaty, J. Kaye y T. Erkinjuntti (Eds.), Evidence-based dementia practice (pp. 428-446). Oxford: Blackwell Publishing.
  • Woods, R.T., Thorgrimsen, L., Spector, A., Royan, L., y Orrell, M. (2006). Improved quality of life and cognitive stimulation in dementia. Aging & Mental Health, 10, 219-226.
  • Zarit, S.H., Zarit, J.M., y Reever, K.E. (1982). Memory training for severe memory loss: Effects on senile dementia patients and their families. The Gerontologist, 22, 373-377.