AJSLP Papers in Press
Published online July 30, 2012
American Journal of Speech-Language Pathology 2012; doi:10.1044/1058-0360(2012/11-0137)

American Journal of Speech-Language Pathology 2013;22:126.

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Article

An Evidence-Based Systematic Review on Cognitive Interventions for Individuals with Dementia

Tammy Hopper
University of Alberta, Edmonton, Alberta (Canada)

Michelle Bourgeois
Ohio State University, Columbus, OH

Jane Pimentel
Eastern Washington University, Spokane, WA

Constance Dean Qualls
State University of New York College at Buffalo, NY

Ellen Hickey
Dalhousie University, Halifax, Nova Scotia (Canada)

Tobi Frymark
Tracy Schooling
ASHA, Rockville, MD

Corresponding Author: Tobi Frymark, National Center for Evidence-based Practice in Communication Disorders, American Speech-Language-Hearing Association, 2200 Research Blvd #245, Rockville, MD 20850-3289, 301-296-8736 (o), 301-296-8588 (f), tfrymark{at}asha.org.

Purpose: The purpose of this review is to evaluate the current state of research evidence related to cognitive interventions for individuals with Alzheimer's disease or related dementias.

Method: A systematic search of the literature was conducted across 27 electronic databases based on a set of a priori questions, inclusion/exclusion criteria and search parameters. Studies were appraised for methodological quality and categorized according to intervention technique and outcome (e.g., cognitive-communication impairment or activity limitation/participation restriction). Results were summarized, and when possible, analyzed quantitatively using indicators of treatment effect size.

Results: Forty-three studies met criteria for inclusion in the review. The most commonly used cognitive intervention techniques used were errorless learning, spaced-retrieval training, vanishing cues, or verbal instruction/cueing. Most treatment outcomes were measured at the cognitive-communication impairment level of functioning, and were generally positive. However, results should be interpreted cautiously due to methodological limitations across studies.

Conclusion: The research evidence is accumulating to support the use of cognitive interventions for individuals with dementia. Researchers are beginning to evaluate treatment efficacy, yet the focus tends to be on discovery, specifically, refining intervention variables that will facilitate optimal outcomes. Implications for clinical practice and avenues for future research are discussed.

Key Words: Alzheimer's disease, dementia, cognitive intervention, speech-language pathology


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