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Aim: The principal aim of the present study was to clarify what type of cognitive decline results in a decrease in the ability to carry out activities of daily living (ADL) in patients with Alzheimer's disease (AD). Methods: The participants comprised 1384 outpatients with mild AD. We used the Mini‐Mental State Examination (MMSE) and Barthel Index (BI) as indicators of basic ADL, and the Lawton Index (LI) as an indicator of instrumental ADL (IADL). We then analyzed the relationships between MMSE and BI, as well as between MMSE and LI. We also carried out a logistic regression analysis with BI and LI subitems as dependent variables, and MMSE subitems as independent variables. Results: For almost all BI and LI subitems, significantly high odds ratios (OR) were noted in MMSE “Copy the design shown” (e.g. dressing OR 3.66, toilet use OR 3.60 and transfers OR 2.80) and “Write a sentence” (e.g. ability to use telephone OR 5.24, laundry OR 2.60, grooming OR 2.50; P < 0.05). Conclusions: Visuospatial cognition had an important effect on the decrease in basic ADL and IADL. Furthermore, the subitems with minimal effect on the decrease of basic ADL and IADL differed. Therefore, it appears that specific activities have little effect on the maintenance of ADL and IADL, and that determining residual cognitive function and utilizing this as a means of compensating for decreased ADL is a useful strategy. Geriatr Gerontol Int 2018; 18: 50–56. [ABSTRACT FROM AUTHOR]

Objects Alzheimer's disease ( AD) is one of the most important diseases in aging society, and non-drug therapy might be an alternative therapeutic approach. Thus, we evaluated the add-on effect of cognitive rehabilitation on AD patients under donepezil treatment. Methods We retrospectively analyzed 55 AD patients with a Mini- Mental State Examination score of 15-25, dividing them into two groups depending on whether they were receiving ambulatory cognitive rehabilitation (group D + R, n = 32) or not (group D, n = 23) in Kurashiki Heisei Hospital over 1 year. The present cognitive rehabilitation included physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. Results Between group D and group D + R, there was no significant difference in baseline data, such as age, Mini- Mental State Examination score, periventricular hyperintensity on magnetic resonance imaging, deep white matter hyperintensity on magnetic resonance imaging or donepezil dose (4.1 mg/day). At 1 year later, however, the Mini- Mental State Examination score improved only in group D + R from 21.7 to 24.0 (** P < 0.001), whereas that of group D remained at 21.5 with both groups of donepezil 5.0 mg/day. Conclusion The combination of cognitive rehabilitation plus a choline esterase inhibitor donepezil showed a better effect for the cognitive function of AD patients than drug only therapy at 1 year. Geriatr Gerontol Int 2016; 16: 200-204. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to evaluate the efficacy of a multidomain program in patients with Alzheimer's disease ( AD). Methods A total of 53 patients with probable AD participated in the present study. The participants were classified to a cognitive programming group ( n = 32) and control group ( n = 21). Participants in the cognitive intervention program received multidomain cognitive stimulation including art, music, recollection and horticultural therapy, each period of intervention lasting 1 h. This program was repeated five times per week over a period of 6 months at the Seongdong-gu Center for Dementia. The Mini- Mental State Examination, the Korean version of Consortium to Establish a Registry for Alzheimer's Disease, Clinical dementia rating scales, and the Korean version of the Quality of Life- Alzheimer's Disease were used to evaluate cognitive ability at baseline and after intervention. After 6 months, cognitive abilities were compared between patients actively participating in cognitive intervention and the pharmacotherapy only group. Results Patients receiving cognitive intervention showed significant cognitive improvement in the word-list recognition and recall test scores versus the control. There was no change in the overall Clinical dementia rating score, but the domain of community affairs showed a significant improvement in the cognitive intervention group. Quality of Life- Alzheimer's Disease of caregivers was slightly improved in the cognitive intervention group after 6 months. Discussion Multidomain cognitive intervention by regional dementia centers has great potential in helping to maintain cognitive function in patients with dementia, increase their social activity and reduce depression, while enhancing the quality of life of caregivers. Geriatr Gerontol Int 2016; 16: 191-199. [ABSTRACT FROM AUTHOR]