Acetylcholinesterase inhibitors and cognitive stimulation, combined and alone, in treating individuals with mild Alzheimer's disease.

Devita, Maria; Masina, Fabio; Mapelli, Daniela; Anselmi, Pasquale; Sergi, Giuseppe; Coin, Alessandra

BACKGROUNDS Acetylcholinesterase inhibitors (AChEI) and cognitive stimulation (CS) are the standard pharmacological and non-pharmacological treatments for Alzheimer's disease (AD). AIMS The aim of this study was to investigate the effects of these treatments, alone or combined, on the neuropsychological profiles of patients with AD. METHODS Forty participants were assigned to three groups receiving either only AChEI (n = 14), AChEI + CS (n = 15), or only CS (n = 11). Cognition was evaluated at baseline and after three months. Linear mixed-effects models were used to investigate differences among the treatments in terms of changes in the patients' neuropsychological profiles. RESULTS Results, although preliminary because of the small sample size, suggest that a general improvement was found in patients who received AChEI + CS and those who received only CS compared with those who received only AChEI. Interestingly, individuals who received only CS showed a significant improvement in immediate memory recall than those who received only AChEI. Furthermore, the group receiving AChEI + CS showed an improvement in delayed recall than the other two groups. DISCUSSION The combination of AChEI and CS seems to have the greatest benefit for patients with mild AD. More interestingly, CS alone is more effective than AChEI alone, even in improving memory, considered to be the "lost" cognitive domain in AD.