Efficacy of Cognitive Interventions in Mild Cognitive Impairment due to Alzheimer's Disease- An Open-Labelled Exploratory Analysis

Efficacy data on nonpharmacotherapy-based interventions such as cognitive retraining and mindfulness meditation on improving neuropsychological functioning in early Alzheimer's disease (AD) are sparse in Indian literature. The objective of the study was to quantify the effect of cognitive retraining (CR) versus mindfulness training (MT) on neuropsychological test performance in patients with early AD. We administered CR and MT strategies in two prospectively enrolled groups of individuals (N = 34) who met the criteria for mild cognitive impairment (MCI) due to AD. Inclusion was based on patient choice and informed consent. One group of 20 patients was imparted supervised CR, and the other group included 14 patients who opted for MT as open-labeled interventions, with group allocation based on participant choice. Paired t test was performed with assessment of baseline and postintervention neuropsychological scores of CR and MT groups. The CR group revealed significant improvement on scores at 3 months (P < 0.05) for Addenbrooke's Cognitive Examination (ACE) subcomponents, particularly total score, memory, visuospatial, and language subscores as well as on Clinical Dementia Rating (CDR) scale. The MT group showed no significant differences on these tests post-intervention with a trend toward improvement on recall scores, and none of the other test scores demonstrated a declining trend. This proof-of-concept study demonstrated significant benefit of CR in improving neuropsychological test performance in patients with MCI due to AD and need to be studied in long-term, multicenter, randomized controlled trials in harmonized groups of patients with MCI and early AD.