The retrogression of the Alzheimer's disease for 5 years through a cognitive rehabilitation intervention. A case report

Background

Although Alzheimer's disease is a neurodegenerative type of dementia, the recent literature suggests that cognitive rehabilitation intervention has satisfactory effects lasting at least for 2 years. We present a case-report of a 78 year high educated old man following such a program and the results of this program.

Materials and methods

The patient met the DSM-IV and NINCDS-ADRDA criteria. Laboratory, neuroimaging exams and detailed neuropsychological assessment were also performed. The neuroimaging data (MRI) showed atrophy of hippocampus and hypometabolism (SPECT) in temporal, parietal and frontal cortical areas. The formal diagnosis was probable Alzheimer's disease. We scheduled an individual cognitive intervention program 5 days a week for 4 months. A follow up, 6 months after the end of the program, showed a clinical and neuropsychological image compatible to normal aging. The following 4 years he was doing cognitive exercises for one hour, 3 times a week. During this program the patient was also treated with a cholinesterase inhibitor.

Results

In the 5th year of the follow up our subject showed a clinical and neuropsychological image of a mild cognitive impairment (MCI) patient. A summary of neuropsychological assessment is as follow: MMSE=25, FRSSD=5, Trail Making A=68”, Trail Making B'=254≵, RBMT: direct and indirect story recall 3 and 0 respectively, Digit Forward and Backward of WAIS-R 5 and 3 respectively, Pyramids and Palm Tree 44/52, Boston Naming Test=36/60, RAVT= 5 (Trial1), 1 (Trial I-V), 3 (Trial V-VI), Verbal fluency=18, Clock design=2/3.

Conclusions

The progress of Alzheimer's disease can be retrograded, in some cases, even for 5 years under a well-structured cognitive intervention program.