REALITY ORIENTATION THERAPY IN ALZHEIMER-DISEASE - USEFUL OR NOT - A CONTROLLED-STUDY

The aim of this controlled study was to evaluate the effects of a long -term program of formal didactic group therapy [class reality orientat ion therapy (ROT)] in Alzheimer disease. The study was conducted in th e day hospital of an Alzheimer Dementia Research and Care Unit (Bresci a, Italy), a multidisciplinary care center providing diagnostic evalua tion and treatment for elderly patients with cognitive impairment. The criteria for the inclusion of patients in the study were mild to mode rate cognitive impairment [Mini Mental Status Examination (MMSE) betwe en 11 and 24/30] and absence of major aphasia, blindness, and overt be havioral disturbances such as wandering or agitation. Sixteen patients constituted the experimental group and 12 the control group. The last cognitive, functional, and affective evaluation in the experimental a nd control group was performed 8.2 and 8.5 months after baseline asses sment, respectively. The experimental group had repeated cycles of 1-m onth ROT classes, and 5-7 weeks was allowed between each cycle. Differ ential change for MMSE score between the two groups was significant. I n the experimental group, there was mild improvement in MMSE score (0. 68 point) at the last assessment, whereas the control group declined ( -2.58 points). This treatment effect on MMSE score (3.27 points) was c ontrolled for potential confounders in a multiple regression analysis. Adjusted treatment effect, including age, education, baseline MMSE, d isease duration, disease severity, number of diseases other than Alzhe imer, and time elapsing from baseline to last assessment, was very sli ghtly lower: 3.12. In the experimental group, treatment effect was eva luated by comparing ROT cycle changes and resting period changes. A cl early significant treatment effect was found for MMSE and verbal fluen cy.