Subscribe to RSS
DOI: 10.1055/s-2001-17427
Direct Interventions for Improving the Performance of Individuals with Alzheimer's Disease
Publication History
Publication Date:
27 September 2001 (online)
![](https://www.thieme-connect.de/media/ssl/200104/lookinside/thumbnails/10.1055-s-2001-17427-1.jpg)
ABSTRACT
Direct interventions are being used increasingly to maintain and improve the communicative and cognitive functioning of patients with Alzheimer's dementia. Speech-language pathologists can play an integral role in maximizing the functioning of dementia patients by selecting appropriate direct interventions that capitalize on spared neuropsychological abilities to compensate for impaired abilities. Successful direct interventions use techniques that facilitate learning and retention of information and skills. In this article, direct intervention techniques-repeated exposure via spaced retrieval training and quizzes; errorless learning; multisensory stimulation using music, toys, pets, and memory wallets; and other approaches to cognitive-linguistic stimulation such as the use of personal computers; the Montessori method; and activity programming-are reviewed. The rationale for use of these direct interventions and available efficacy data with Alzheimer's patients also are presented.
KEYWORD
Direct interventions - dementia - Alzheimer's disease
REFERENCES
- 1 Cummings J L, Benson D F. Dementia: A Clinical Approach. Boston: Butterworth Publishers; 1983
- 2 Clark L W. Interventions for persons with Alzheimer's disease: strategies for maintaining and enhancing communicative success. Top Lang Disord . 1995; 15 47-66
- 3 Arkin S M. Alzheimer memory training: students replicate learning successes. Am J Alzheimer's Dis . 2000; 15 152-162
- 4 Brush J A, Camp C J. Using spaced retrieval as an intervention during speech-language therapy. Clin Gerontol . 1998; 19 51-64
- 5 Bourgeois M S, Mason L A. Memory wallet intervention in an adult day-care setting. Behav Intervent . 1996; 11 3-18
- 6 Quayhagen M P, Quayhagen M, Corbeil R R, Roth P A, Rodgers J A. A dyadic remediation program for care recipients with dementia. Nurs Res . 1995; 44 153-159
- 7 Bayles K A, Tomoeda C K. Improving Function in Dementia and Other Cognitive-Linguistic Disorders: a Guide and Resource Book. Tucson, AZ: Canyonlands Publishing; 1997
- 8 Collins A M, Loftus E F. A spreading activation theory of semantic processing. Psychol Rev . 1975; 82 407-428
- 9 Schacter D L. Searching for memory: the brain, the mind, and the past. New York: Harper-Collins; 1996
- 10 Maki P M, Knopman D S. Limitations of the distinction between conceptual and perceptual implicit memory: a study of Alzheimer's disease. Neuropsychology . 1996; 10 464-474
- 11 Vaidya C J, Gabrieli J DE, Lange K L, Fleischman D A. Dissociable conceptual priming processes: evidence from Alzheimer's disease. Soc Neurosci Abst . 1996; 22 1449
- 12 Fleischman D A, Gabrieli J DE. Repetition priming in normal aging and Alzheimer's disease: a review of findings and new theories. Psychol Aging . 1998; 13 88-119
- 13 Glisky E L. Rehabilitation and memory disorders: tapping into preserved mechanisms. Rotman Institute Abstracts. Brain Cogn . 1997; 35 291-292
- 14 Rau M T. Coping with Communication Challenges in Alzheimer's Disease. San Diego, CA: Singular Publishing Group; 1993
- 15 Grower R, Wallace C, Weinstein G. Approaches to special programming. In: Aronson MK, ed. Reshaping Dementia Care: Practice and Policy in Long-Term Care Thousand Oaks, CA: Sage Publications 1994: 43-59
- 16 Little A G, Volans P J, Hemsley D R, Levy R. The retention of new information in senile dementia. Br J Clin Psychol . 1986; 25 71-72
- 17 Small J A, Kemper S, Lyons K. Sentence comprehension in Alzheimer's disease: effects of grammatical complexity, speech rate, and repetition. Psychol Aging . 1997; 12 3-11
- 18 Heun R, Burkart M, Benkert O. Improvement of picture recall by repetition in patients with dementia of the Alzheimer type. Int J Geriatr Psychiatry . 1997; 12 85-92
- 19 Mahendra N. Effect of Encoding Conditions on Episodic Memory in Aging and Dementia. Tucson, AZ: The University of Arizona; 2001. Unpublished doctoral dissertation
- 20 Arkin S M. Alzheimer memory training: quiz beats repetition, especially for more impaired. Am J Alzheimer's Dis . 1997; 12 147-158
- 21 Slamecka N J, Graf P. The generation effect: delineation of a phenomenon. Hum Learning Memory . 1978; 4 592-604
- 22 Mitchell D B, Hunt R R, Scmitt F A. The generation effect and reality monitoring: evidence from dementia and normal aging. J Gerontol . 1986; 41 79-84
- 23 Martin A. Representation of semantic and spatial knowledge in Alzheimer's patients: implications for models of preserved learning in amnesia. J Clin Exper Neuropsychol . 1987; 9 191-224
- 24 Craik F IM. Age-related changes in human memory. In: Park D, Schwarz N, eds. Cognitive Aging: A Primer Philadelphia: Psychology Press 2000: 75-92
- 25 Dick M B. Motor and procedural memory in Alzheimer's disease. In: Baeckman L, ed. Memory Function in Dementia Amsterdam: North-Holland 1992: 135-150
- 26 Baeckman L. Memory training and memory improvement in Alzheimer's disease: rules and exceptions. Acta Neurol Scand . 1992; 84 84-89
- 27 Zanetti O, Binetti G, Magni E. Procedural memory stimulation in Alzheimer's disease: impact of a training program. Acta Neurol Scand . 1997; 95 152-157
- 28 Baddeley A, Wilson B A. When implicit learning fails: amnesia and the problem of error elimination. Neuropsychologia . 1994; 32 53-68
- 29 Morris R G. Recent developments in the neuropsychology of dementia. Int Rev Psychiatry . 1994; 6 85-107
- 30 Perry R J, Watson P, Hodges J R. The nature and staging of attention dysfunction in early Alzheimer's disease: relationship to episodic and semantic memory impairment. Neuropsychologia . 2000; 38 252-271
- 31 Nebes R D. Alzheimer's disease: cognitive neuropsychological aspects. In: Feinberg TE, Farah MJ, eds. Behavioral Neurology and Neuropsychology New York: McGraw-Hill Publishers 1997: 545-550
- 32 Baddeley A D, Della Sala S, Spinnler H. The two-component hypothesis of memory deficit in Alzheimer's disease. J Clin Exper Neuropsychol . 1991; 13 372-380
- 33 Filoteo J V, Delis D C, Massman P J. Directed and divided attention in Alzheimer's disease: impairment in shifting attention to global and local stimuli. J Clin Exper Neuropsychol . 1992; 14 871-883
- 34 Camicioli R, Howieson D, Lehman S, Kaye J. Talking while walking: the effect of a dual task in aging and Alzheimer's disease. Neurology . 1997; 48 955-958
- 35 Bourgeois M S, Burgio L D, Schultz R, Beach S, Palmer B. Modifying repetitive verbalizations of community-dwelling patients with Alzheimer's disease. Gerontologist . 1997; 37 30-39
- 36 Brush J A, Camp C J. Spaced retrieval during dysphagia therapy: a case study. Clin Gerontol . 1998; 19 96-99
- 37 Landaeur T K, Bjork R A. Optimum rehearsal patterns and name learning. In: Grunenberg MM, Morriss PE, Sykes RN, eds. Practical Aspects of Memory New York: Academic Press 1978: 625-632
- 38 Schacter D L. Understanding implicit memory. Am Psychol . 1992; 47 559-569
- 39 Scott L C, Wright G K, Rai G S, Exton-Smith A N. Further evidence of preserved memory function in Alzheimer's disease. Int J Geriatr Psychiatry . 1991; 6 583-588
- 40 Camp C J, Foss J W, O'Hanlon A M, Stevens A B. Memory interventions for persons with dementia. Appl Cogn Psychol. 1995; 9 374.1-374.18
- 41 Abrahams J P, Camp C J. Maintenance and generalization of object naming training in anomia associated with degenerative dementia. Clin Gerontol . 1993; 12 57-72
- 42 McKitrick L A, Camp C J. Relearning the names of things: the spaced retrieval intervention implemented by caregivers. Clin Gerontol . 1993; 14 60-62
- 43 Cherry K E, Simmons S S, Camp C J. Spaced retrieval enhances memory in older adults with probable Alzheimer's disease. J Clin Geropsychol . 1999; 5 159-175
- 44 McKitrick L A, Camp C J. Name and location learning in DAT with spaced retrieval. Paper presented at the annual convention of the American Psychological Association, New Orleans, Louisiana, August 1989
- 45 Camp C J. Facilitation of new learning in Alzheimer's disease. In: Gilmore GC, Whitehouse PJ, Wykle ML, eds. Memory and aging: Theory, research, and practice New York: Springer 1989: 212-225
- 46 Schacter D L, Rich S A, Stampp M S. Remediation of memory disorders: an experimental evaluation of the spaced retrieval technique. J Clin Exper Neuropsychol . 1985; 7 79-96
- 47 Camp C J, Foss J W, Stevens A B, O'Hanlon A M. Improving prospective memory task performance in persons with Alzheimer's disease. In: Brandimonte M, Einstein GO, McDaniel MA, eds. Prospective Memory: Theory and Applications Mahwah, NJ: Lawrence Erlbaum Associates 1996: 351-367
- 48 Hopper T. Cognitive linguistic interventions and spaced retrieval training for individuals with Alzheimer's disease. In: Bayles KA, Tomoeda CK, Hopper T, Mahendra N, Cleary S, eds. Improving the Functioning of Dementia Patients: An Emerging Science. Miniseminar presentation at the American Speech-Language-Hearing Association Convention, San Antonio, Texas, November, 1998
- 49 Arkin S M, Rose C, Hopper T. Implicit and explicit learning gains in Alzheimer's patients: effects of naming and information retrieval training. Aphasiology . 2000; 14 723-742
- 50 Arkin S M, Mahendra N. Structured Information Retrieval Training Yields Implicit and Explicit Learning Gains in Alzheimer's Patients. Poster presentation at the 28th Annual Meeting of the International Neuropsychological Society, Denver, Colorado, February, 2000
- 51 Arkin S M. Alzheimer memory training: positive successes replicated. Am J Alzheimer's Dis . 1998; 13 102-104
- 52 Wilson B A, Carter G, Norris D, Page M. Does Errorless Learning Work Through Implicit or Explicit Memory?. Poster presentation at the 29th Annual Meeting of the International Neuropsychological Society, Chicago, Illinois, 2001
- 53 Wilson B A, Baddeley A D, Evans J, Shiel A. Errorless learning in the rehabilitation of memory impaired people. Neuropsychol Rehabil . 1999; 4 307-326
- 54 Squires E J, Hunkin N M, Parkin A J. Errorless learning of novel associations in amnesia. Neuropsychologia . 1997; 35 1103-1111
- 55 Llorente C, Gaffan E A. Coin identification and relative value: a training program for adults with a mental handicap. Behav Psychother . 1989; 17 332-346
- 56 Clare L, Wilson B A, Breen E K, Hodges J R. Errorless learning of face-name associations in early Alzheimer's disease. Neurocase: Case Studies in Neuropsychology, Neuropsychiatry, and Behavioral Neurology . 1999; 5 37-46
- 57 Clare L, Wilson B A, Carter G. Intervening with everyday memory problems in dementia of the Alzheimer type: an errorless learning approach. J Clin Exper Neuropsychol . 2000; 22 132-146
- 58 Bright R. The use of music therapy and activities with dementia patients who are deemed ``difficult to manage''. Clin Gerontol . 1986; 6 131-144
- 59 Summer L. Guided imagery and music with the elderly. Music Ther . 1981; 1 39-42
- 60 Christie M E. Music therapy applications in a skilled and intermediate care nursing home facility: a clinical study. Activities, Adaptation & Aging . 1992; 16 69-87
- 61 VanderArk S. The effects of music participation on quality of life in the elderly. Music Ther . 1983; 3 71-81
- 62 Casby J A, Holm M B. The effect of music on repetitive disruptive vocalizations of persons with dementia. Am J Occup Ther . 1994; 48 883-889
- 63 Denney A. Quiet music: an intervention for mealtime agitation?. J Gerontol Nurs . 1997; 23 16-23
- 64 Ragneskog H. Influence of dinner music on food intake and symptoms common in dementia. Scand J Caring Sci . 1996; 10 11-17
- 65 Mahendra N. Manipulation of working memory through sensory stimulation. In: Bayles KA, Hopper T, Mahendra N, Cleary S, Tomoeda CK, eds. What Works with Dementia Patients and Why. Short course presented at the American Speech-Language-Hearing Association Convention, San Francisco, California, November 1999
- 66 Hopper T L, Bayles K A, Tomoeda C K. Using toys to stimulate communicative function in individuals with Alzheimer's disease. J Med Speech Lang Pathol . 1998; 6 73-80
- 67 Bailey J, Gilbert E, Herweyer S. To find a soul. Nursing . 1992; 22 63-64
- 68 Francis G, Baly A. Plush animals: Do they make a difference?. Geriatr Nurs . 1986; 74 140-143
- 69 Kongable L G, Buckwalter K C, Stolley J M. The effects of pet therapy on the social behavior of institutionalized Alzheimer's clients. Arch Psychiatr Nurs . 1989; 3 191-198
- 70 Damon J, May R. The effects of pet facilitative therapy on patients and staff in an adult day care center. Activities, Adaptation & Aging . 1997; 8 117-131
- 71 Batson K, McCabe B, Baun M, Wilson C. The effect of a therapy dog on socialization and physiological indicators of stress in persons diagnosed with Alzheimer's disease. In: Wilson C, Turner DC, eds. Companion Animals in Human Health Thousand Oaks, CA: Sage Publications 1998: 203-215
- 72 Bourgeois M S. Enhancing conversational skills in patients with Alzheimer's disease using a prosthetic memory aid. J Appl Behav Anal . 1990; 23 29-42
- 73 Mahendra N, Bayles K A, Tomoeda C K. Computer-Assisted Cognitive Stimulation. Presentation at the Annual Convention of the Arizona Speech & Hearing Association, Tucson, Arizona, April, 2000
- 74 Schreiber M, Schweizer A, Lutz K, Kalveram K L, Jancke L. Potential of an interactive computer-based training in the rehabilitation of dementia: an initial study. Neuropsychol Rehab . 1999; 9 155-167
- 75 Stachowiak F J. Computers in aphasia rehabilitation. In: Christensen A, Uzzell BP, eds. Brain Injury and Neuropsychological Rehabilitation: International Perspectives Mahwah, NJ: Lawrence Erlbaum Associates 1994: 133-160
- 76 Katz R C. Computer Applications in Aphasia Rehabilitation. Telerounds No. 38: Nationally Televised Educational Series, National Center for Neurogenic Communication Disorders, University of Arizona. Copyright © Arizona Board of Regents, 1997
- 77 Stern H, Jeaco S, Millar T. Computers in neurorehabilitation: what role do they play?. <~>Part 1. Br J Occup Ther . 1999; 62 549-553
- 78 Glisky E L, Schacter D L. Acquisition of domain-specific knowledge in organic amnesia: training for computer-related work. Neuropsychology . 1987; 25 893-906
- 79 Glisky E L. Acquisition and transfer of word processing skill by an amnesic patient. Neuropsychol Rehab . 1995; 5 299-318
- 80 Brooks B M, Mcneil J E, Rose F D. Route learning in a case of amnesia: a preliminary investigation into the efficacy of training in a virtual environment. Neuropsychol Rehab . 1999; 9 63-76
- 81 Arkin S M. Alzheimer rehabilitation by students: interventions and outcomes. Neuropsychol Rehab . 2001 (in press) ;
- 82 Arkin S M. Alzheimer Rehab Program Maintains Cognitive and Language Function, Improves Fitness: First Year Results. Paper presented at the International Neuropsychological Society Conference, Durban, South Africa, July, 1999
- 83 Johnson K, Bourgeois M. Language interventions for patients with dementia attending a respite program. SID 2 Newsletter . 1998; 8 11-16
- 84 Vance D, Camp C J, Kabacoff M, Greenwalt L. Montessori methods: innovative interventions for adults with Alzheimer's disease. Montessori Life . 1996; 8 10-12
- 85 Dreher B B. Montessori and Alzheimer's: a partnership that works. Am J Alzheimer's Dis . 1997; 12 138-140
- 86 Judge K S, Camp C J, Orsulic-Jeras S. Use of Montessori-based activities for clients with dementia in adult day care: effects on engagement. Am J Alzheimer's Dis . 2000; 15 42-46
- 87 Camp C J, Brush J A. Montessori-based Interventions for Persons with Dementia. Telerounds No. 46: Nationally Televised Educational Series, National Center for Neurogenic Communication Disorders, University of Arizona. Copyright © Arizona Board of Regents, 1999