Memory rehabilitation in Alzheimer's disease: a review of progress

Background Memory rehabilitation is a sadly misrepresented area of applied research in Alzheimer's disease, Objectives To gather and evaluate recent evidence for the clinical effectiv eness or ecologically validity of memory rehabilitation for mild to moderat e Alzheimer's patients. Methods Computerised searches and some handsearching were conducted spannin g the last five years, from 1995 to 2000, inclusively. Criteria for inclusi on in this overview involved the use of a precise memory rehabilitation tec hnique within an experimental study design applied to Alzheimer's patients with pre- and post-treatment evaluation. Findings Three potential levels of memory rehabilitation procedures with pr oven clinical or pragmatic efficacy were identified. The first level bears on the facilitation of residual explicit memory with structured support bot h at encoding and at subsequent recall; the second level of memory rehabili tation exploits the relatively intact implicit memory system (priming and p rocedural memory); the last deals with finding ways of coping with the pati ent's limited explicit memory capacities through the use of external memory aids. A proposal of suggestions for good practice and future research in m emory rehabilitation is also offered with the hope to spur further developm ent in this rapidly expanding area of applied research. Conclusion The available evidence shows that alternative and innovative way s of memory rehabilitation for Alzheimer's patients can indeed be clinicall y effective or pragmatically useful with a great potential for use within t he new culture of a more graded and proactive type of Alzheimer's disease c are. Copyright (C) 2001 John Wiley & Sons, Ltd.