Poster Presentations: P2 P495

Conclusions: As most people with advanced dementia in India die in their

own homes or hospitals, there are training needs to be addressed as well.

P2-370 COGNITIVE BEHAVIORALTHERAPY TO

ENHANCE COGNITIVE REHABILITATION

EFFICACY IN ALZHEIMER’S DISEASE

Megan Fane1, Paul Lysaker2, Joanna Fiszdon3, Elizabeth Twamley4,

Amanda Gooding5, Casey Baginski1, Jimmy Choi1, 1Columbia University

Medical Center, New York, New York, United States; 2Indiana University

School of Medicine, Indianapolis, Indiana, United States; 3Yale University

School of Medicine, West Haven, Connecticut, United States; 4University of

California San Diego, San Diego, California, United States; 5Fordham

University, Bronx, New York, United States. Contact e-mail: fanemeg@

nyspi.columbia.edu

Background: While cognitive rehabilitation (CR) programs for individuals

with dementing pathology have been shown to be moderately efficacious, as

a stand-alone treatment, they can be difficult for this group of patients, as

they serve as a constant reminder of cognitive deficits, which can lead to

low self-esteem and a sense of hopelessness. Because of these limitations of

standard CR programs, add-on therapies directly targeting hopelessness and

self-esteem may enhance the efficacy of CR. Methods: 47outpatients diag-

nosed with early to moderate Alzheimer’s disease(AD) were randomly as-

signed to 4 months of (1) computer-based memory training (MT), or (2)

a newly designed cognitive behavioral therapy (CBT) regimen in conjunction

with the same MT(CBT-MT) designed to target automatic distorted schemes

of hopelessness and perceptions of poor self-competency for the training ex-

ercises. Assessments of cognitive function, quality of life, neuropsychiatric

symptoms, treatment adherence, depression, hopelessness, treatment motiva-

tion, and perceptions of self-efficacy were conducted at intake and immedi-

ately following treatment conclusion. Results: Patients in CBT-MT

reported less overall depressive symptoms at post treatment and reported

greater willingness and efficacy to tackle the challenging exercises in the

CR program. Subsequently, the CBT-MT group had less treatment attrition

in CR compared to theMT group. Of note, greater perceptions of self-efficacy

for the training at baseline significantly predicted memory outcome and ac-

counted for 49% of the variance (R2¼.49, F [3,43]¼5.14; p¼.001) followed

by baseline mental flexibility, which explained another 20% (R2¼.20,

F [3,43]¼4.74; p¼.01).Depression severity and neuropsychiatric symptoms

did not contribute to memory outcome beyond what was found in the model.

Conclusions: Findings suggest that enhancing CR treatments with add-on in-

terventions directly targeting self-efficacy may increase their effectiveness.

Specifically, these add-on treatments may be effective by directly increasing

elements of control, self-efficacy, and intrinsic motivation for treatment, lead-

ing to both psychological and neuropsychological benefits. The potential use

of these types of add-on treatments in individuals in prodromal stages of de-

mentia (mild cognitive impairment) will also be discussed.

P2-371 A MULTICENTER, RANDOMIZED TRIALTO

ASSESS EFFICACYOFHOME-BASEDANDGROUP

COGNITIVE INTERVENTION PROGRAMS IN

AMNESTIC MILD COGNITIVE IMPAIRMENT

Hae Ri Na1, Seong Choi2, Jee H. Jeong3, Duk Na4, Sun Ah Park5, Eun-

Joo Kim6, Sang Won Seo7, Hyun Jeong Han8, Han Seol-Heui9, Jae-

Hong Lee10, So Moon11, Kyung Won Park12, 1Bobath Memorial Hospital,

Seongnam-Si, Kyungki-Do, South Korea; 2Inha University School of

Medicine, Incheon, South Korea; 3Ewha Womans University School of

Medicine, Seoul, South Korea; 4Samsung Medical Center, Sungkyunkwan

University School of Medicine, Seoul, South Korea; 5Soonchunhyang

University Bucheon Hospital, Bucheon, Gyeonggi-Do, South Korea; 6Pusan

University Hospital, Busan, South Korea; 7Samsung Medical Center,

Sungkyunkwan University School of Medicine, Seoul, South Korea;8Department of Neurology Myongji Hospital, Goyang, South Korea;9Konkuk University School of Medicine, Seoul, South Korea; 10Austin

Health, Heidelberg, VIC, Australia; 11Ajou University Hospital, Suwon,

South Korea; 12Dong-A University College of Medicine, Busan, South

Korea. Contact e-mail: seonghye@inha.ac.kr

Background:The efficacy of cognitive intervention programs remains to be

verified using a randomized trial with standardized intervention in mild cog-

nitive impairment (MCI). The effectiveness of home-based cognitive inter-

vention programs have never been studied in MCI. The objective of this

study was to investigate the efficacy of a group cognitive intervention and

a home-based cognitive intervention about cognitive function in amnestic

MCI (aMCI). Methods: Using a randomized control design, 297 partici-

pants with MCI were randomly assigned to a group cognitive intervention,

a home-based cognitive intervention, or waitlist control group. The inter-

vention was a multicomponent cognitive intervention which focused on

teaching prospective and episodic memory strategies and using them in their

daily life. Participants were assessed on primary measure of the modified

Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-Cog) at

baseline, post-intervention, and 12 weeks’ and 24 weeks’ follow-up. Sec-

ondary measures evaluated memory, cognition, behavior, quality of life,

and function. Results: Overall, 99 and 98 participants received group cog-

nitive intervention and home-based cognitive intervention, respectively, for

12weeks. Of these, about 70% of the participants completed the interven-

tion. We noted a significant decrease in modified ADAS-Cog (-2.766.1

vs. -0.8265.1, p ¼0.02) and Clinical Dementia Rating Sum of Boxes

(CDR-SB) scores (-0.2160.64 vs. 0.0460.56, p ¼0.01) in favor of home-

based cognitive intervention compared to the waitlist control group at the

post-intervention point. There was a significant group effect on modified

ADAS-cog through the all assessment points between home-based cognitive

intervention and controls (p ¼0.02). The interaction effect on modified

ADAS-cog was significant between the assessment phase effect and the

group (group cognitive intervention versus controls) (p ¼0.048). Conclu-

sions: Home-based cognitive intervention and group cognitive intervention

could be useful to improve cognition in aMCI.

P2-372 NON- PHARMACOLOGIC INTERVENTION IN

PEOPLE WITH DEMENTIA IN BRAZIL: AN

OVERVIEW

Jacqueline Abrisqueta-Gomez1, Karen Rosangela Silva De Souza

Saviotti2, Carmen Silvia Calandria Ponce3, Flavia Lorenzini Valenca

Locatelli4, Deolinda Lacerda F Batista4, 1Check up do Cerebro/Brain

Checkup - Consulting and Research in Cognitive Neurosciences, Sao Paulo

SP, Brazil; 2INTEGRARTE Centro de Atividades, Belo Horizonte/MG,

Brazil; 3Brain Checkup - Consulting and Research in Cognitive

Neurosciences, Sao Paulo, Brazil; 4Brain Checkup - Consulting and

Research in Cognitive Neurosciences., Sao Paulo/SP, Brazil.

Contact e-mail: jacky_ag@hotmail.com

Background: The challenges to governments to respond to the growing num-

bers of peoplewith dementia are substantial. A broad public health approach is

needed to improve the care andquality of life of peoplewith dementia and fam-

ily caregivers. Pharmacologic approaches, have modest benefits and some

risks. Some non-pharmacologic interventions (NPIs) have been shown to be

safe and can help to reduce the impact of cognitive, emotional and behavioral

symptoms. In Brazil there are few institutions and professionals working in

this field. Thus, our objective is to identify the national scientific production

on this matter. Methods: The search was conducted through Brazilian

Cochrane Center, together with the LILACS andMedline scientific databases.

We included all papers published up to 2012 by Brazilian groups. For the

search, the following key words were used: cognitive rehabilitation, neuro-

psychological rehabilitation, cognitive training, memory stimulation, prob-

lem solving, reality orientation, validation, reminiscence, ADL training,

external aid, memory aid, electronic aids, occupational therapy, music ther-

apy, transcranial stimulation, multisensory stimulation, physical exercise,

art therapy, massage and touch, recreation activities, social skills of commu-

nication, behavioral management, quality of life, well-being support group,

education, coping, training, day care, home care, comprehensive support.

Key words were crossed with the term [dementia OR cognitive impairment

OR Alzheimer OR caregivers]. Results: Eighteen articles were found, being

9 correspondent to cognitive intervention (cognitive or neuropsychological