Acessibilidade / Reportar erro

Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: A review of the literature

Reabilitação cognitiva de déficits neuropsicológicos e transtorno cognitivo leve: revisão da literatura

Abstract

Neuropsychological rehabilitation is related to the treatment or optimization of disabilities, handicaps and cognitive deficiencies including emotional, behavioral and personality alterations, aiming at the best cognitive, neurobiological and social re-adaptation.

Objective:

The main aim of this paper is to review scientific studies published over the last five years on cognitive training with rehabilitation, focusing on elderly subjects with cognitive complaints and patients diagnosed with MCI.

Methods:

Data were generated from Medline, PsychoInfo and EMBASE including publications from 2002 to 2007 using the search terms "Mild Cognitive Impairment", "Cognitive Complaints", "Rehabilitation" and "Intervention Studies". Data collection criteria were restricted to the quality of evidence Class I.

Results:

Eight articles out of sixty eight previously selected were chosen because of their randomized studies, including techniques of cognitive rehabilitation in patients with cognitive complaints, MCI and neuropsychological training.

Conclusions:

The studies showing generalization of rehabilitation techniques to practical real life situations and use of an errorless learning approach were considered more effective in terms of maintaining treatment follow up, although further studies are recommended.

Key words:
mild cognitive impairment; neuropsychological rehabilitation; cognitive training

Resumo

A reabilitação cognitiva se ocupa do tratamento e otimização das incapacidades, desvantagens e deficiências cognitivas, bem como de alterações emocionais, comportamentais e de personalidade. Visa a melhor readaptação neuropsicológica, neurobiológica e social.

Objetivo:

Realizar revisão literária sobre os estudos científicos publicados nos últimos cinco anos em reabilitação cognitiva, em sujeitos com queixas cognitivas e pacientes idosos diagnosticados com TCL.

Métodos:

As informações foram obtidas nas bases de dados Mediline, PsychoInfo e EMBASE com recomendações baseadas na qualidade de evidência Classe I.

Resultados:

Foram encontrados 68 artigos. Destes, selecionados oito, por caracterizarem estudos randomizados, incluir técnicas de reabilitação cognitiva em pacientes com queixas cognitivas e TCL e por documentarem avaliações neuropsicológicas.

Conclusões:

As pesquisas que demonstraram técnicas de reabilitação com abordagens capazes de generalização para as atividades práticas da vida e uso da abordagem aprendizagem sem erro se mostraram mais efetivas quanto à manutenção no seguimento, contudo, são necessários estudos mais detalhados.

Palavras-chave:
transtorno cognitivo leve; reabilitação neuropsicológica e treino cognitivo

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Full text available only in PDF format.

References

  • 1
    IBGE: Estimativas anuais e mensais da população do Brasil e das unidades da federação: 1980-2020. Metodologias Estimativas das populações municipais. Acessado em 28/11/2007. http://www.ibge.gov.br/brasil_em_sintese/default.htm
    » http://www.ibge.gov.br/brasil_em_sintese/default.htm
  • 2
    Ávila R, Miotto E. Reabilitação Neuropsicológica de déficits de memória em pacientes com demência de Alzheimer. Rev Psiq Clin 2002;29:190-196.
  • 3
    Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol 1999;56:303-308.
  • 4
    Petersen RC, Doody R, Kurz A, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985-1992.
  • 5
    Petersen, RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004; 256:183-194.
  • 6
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Ed. Washington, DC: American Psychiatric Association; 1994.
  • 7
    De Vreese LP, Neri M, Fioravanti M, BelL OI, Zanetti O. Memory rehabilitation in Alzheimer's: a Review of Progress. Int J Geriatr Psychiatry 2001;16:794-809.
  • 8
    Larrieu S, Letenneur L, Orgogozo JM, et al. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002;59:1594-1599.
  • 9
    Belleville S. Cognitive training for persons with mild cognitive impairment - MCI Conference Paper. Int Psychogeriatr 2008;20:57-66.
  • 10
    Artero S, Ritchie K. The detection of Mild Cognitive Impairment in the general practice setting. Aging Ment Health, 2003;7:251-258.
  • 11
    Fisk JD, Merry HR, Rockwood K. Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology 2003;61:1179-1184.
  • 12
    Bottino CMC, Moreno MDPQ. Comprometimento cognitivo leve: Critérios diagnósticos e validade clínica. In: Bottino CMC, Laks J, Blay SL, editores. Demência e transtornos cognitivos em idosos. Rio de Janeiro: Guanabara Koogan; 2006.
  • 13
    Morris LC, Storandt M, Miller JP, et al. Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol 2001;58:397-405.
  • 14
    Boyle PA, Wilson RS, Aggarwal NT, Tang Y, Bennett DA. Mild cognitive impairment: Risk of Alzheimer disease and rate of cognitive decline. Neurology 2006;67: 441-445.
  • 15
    Pérès K, Chrysostome V, Fabrigoule C, Orgogozo JM, Dartigues JF, Barberger-Gateau P. Restriction in complex activities of daily living in MCI - Impact on outcome. Neurology 2006;67:461-466.
  • 16
    Belleville S, Gilbert B, Fontaine F, Gagnon L, Ménard É, Gauthier S. Improvement of episodic memory in persons with mild cognitive impairment and healthy adults: evidence from a cognitive intervention program. Dement Geriatr Cogn Disord 2006;22:486-499.
  • 17
    Perrotin A, Belleville S, Isingrini M. Metamemory monitoring in mild cognitive impairment: Evidence of a less accurate episodic feeling-of-knowing. Neuropsychologia 2007;45:2811-2826.
  • 18
    Portet F, Ousset PJ, Visser PJ, et al. Mild Cognitive Impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry 2006;77:714-718.
  • 19
    Wilson BA. Reabilitação das Deficiências Cognitivas, In: Nitrini R, Caramelli P, Mansur LL, editores. Neuropsicologia das Bases Anatômicas à Reabilitação. São Paulo, Clínica Neurológica HC-FMUSP; 1996.
  • 20
    Wilson BA. Avanços recentes em reabilitação neuropsicológica. In: Miotto EC, Lúcia MCS, Scaff M, editores. Neuropsicologia e as Interfaces com as Neurociências - São Paulo: Casa do Psicólogo; 2007.
  • 21
    Robertson I.H. Goal Management training: A clinical manual. Cambridge, UK: PsyConsult; 1996.
  • 22
    Duncan J. Attention, Intelligence, and the frontal lobes, In: Gazzaniga MS, editor. The cognitive neurosciences. Cambridge, MA: MIT press; 1995.
  • 23
    Baddeley AD, Wilson BA. When implicit learning fails: amnesia and the problem of error elimination. Neuropsychologia 1994;32: 53-68.
  • 24
    Tonetta M. II TNP, un software che opera in ambiente Windows. Atti del 4 Convegno Nazionale Informatica, Didattic e Disabilità. Napoli, (in Italian); 1995.
  • 25
    Tonetta M. Riabilitazione neuropsicológica e TNP (training neuropsicológico). Aspetti teorici e pragmatici. New Magazine Publisher, Trento (in Italian); 1998.
  • 26
    Cipriani G, Bianchetti A, Trabucchi M. Outcomes of a computer-based cognitive rehabilitation program on Alzheimer's disease patients compared with those on patients affected by mild cognitive impairment. Arch Gerontol Geriatr 2006;43:327-335.
  • 27
    Ala TA, Berck G, Popovich AM. Using the telephone to call for help and caregiver awareness in Alzheimer disease. Alzheimer Dis Assoc Disord 2005;19:79-84.
  • 28
    Salloway S, Correia S, Richardson S. Key lessons learned from short-term treatment trials of cholinesterase inhibitors for amnestic MCI. Int Psychogeriatr 2008;20:40-46.
  • 29
    American Academy of Neurology - Clinical Practice Guideline Process Manual. Approved by the AAN Board of Directors January, 2004.
  • 30
    Brainin A, Barnes M, Baron JC, et al. Guidance for the preparation of neurological management guidelines by EFNS scientific task forces - revised recommendations 2004. Eur J Neurol 2004;11:577-581.
  • 31
    Levine B, Stuss DT, Winocur W, et al. Cognitive rehabilitation in the elderly: Effects on strategic behavior in relation to goal management. J Int Neuropsychol Society 2007;13:143-152.
  • 32
    Winocur G, Craik FIM, Levine B, et al. Cognitive rehabilitation in the elderly: Overview and future directions. J Int Neuropsychol Society 2007;13:166-171.
  • 33
    Levine B, Robertson IH, Clare L, et al. Rehabilitation of executive functioning: An experimental-clinical validation of Goal Management Training. J Int Neuropsychol Society 2000;6:299-312.
  • 34
    Talassi E, Guerrecshi M, Feriani M, Fedi V, Bianchetti A, Trabucci M. Effectiveness of a cognitive rehabilitation program in mild dementia (MD) and mild cognitive impairment (MCI): a case control study. Arch Gerontol Geriatr 2007;44(Suppl 1):391-399.
  • 35
    Akhtar S, Moulin CJA, Bowie PCW. Are people with mild cognitive impairment aware of the benefits of errorless learning? Neuropsychol Rehabil 2006;16:329-346.
  • 36
    Ball K, Edwards JD, Ross LA. The impact of speed of processing training on cognitive and everyday functions. J Gerontol B Psychol Sci Soc Sci 2007; 62B:19-31.
  • 37
    Ball K, Berch DB, Helmers KF, et al. Effects of cognitive training interventions with older adults: A randomized controlled trial. J Am Med Assoc 2002;288:2271-2281.
  • 38
    Rozzini L, Costardi D, Chilovi VB, Franzoni S, Trabucchi M, Padovani A. Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors. Int J Geriatr Psychiatry 2007;22:356-360.
  • 39
    Clare L, Woods RT. Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer's disease: A review. Neuropsychol Rehabil 2004;14:385-401.
  • 40
    Clare L, Marková I, Verhey F, Kenny G. Awareness in dementia: A review of assessment methods and measures. Aging Ment Health, 2005;9:394-413.

Publication Dates

  • Publication in this collection
    Apr-Jun 2008

History

  • Received
    24 Mar 2008
  • Accepted
    20 May 2008
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
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