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Therapeutic Psychosocial Intervention for Elderly Subjects With Very Mild Alzheimer Disease in a Community: The Tajiri Project

Ishizaki, Junichi*; Meguro, Kenichi*; Ohe, Kyoko; Kimura, Etsuko; Tsuchiya, Emiko; Ishii, Hiroshi*†; Sekita, Yasuyoshi; Yamadori, Atsushi*

Alzheimer Disease & Associated Disorders: October-December 2002 - Volume 16 - Issue 4 - p 261-269

Elderly subjects with mild memory impairment but not apparent dementia are the focus of early intervention trials. To examine the effects of structural psychosocial intervention for elderly subjects with very mild Alzheimer disease, i.e., Clinical Dementia Rating 0.5. The design is a prospective study. The experimental group (14 Clinical Dementia Rating 0.5 subjects) and the control group (11 Clinical Dementia Rating 0.5 subjects) were studied. Subjects with cerebrovascular disease as shown by magnetic resonance imaging were excluded. The experimental group participated in activities in a day-care-like setting once a week over a period of 6 months, whereas the control group did not. Each group was reevaluated after approximately 9 months. The effects of intervention were evaluated by cognitive tests, affective scales, a global clinical measure, an observation scale in the sessions, and a projective test. The experimental group showed a significant improvement on the word fluency test, whereas the control group showed a significant decline on the Mini-Mental State Examination, the digit span, and the Trail Making-A test. The experimental group revealed significantly higher levels on the Mini-Mental State Examination and the digit span compared with the control group after the 6-month intervention. A significant improvement was found for the global clinical measure, the observation scale, and the projective test in the experimental group after the intervention. After controlling the potential confounders (age, educational level, baseline cognitive, and affective status) in a multiple regression analysis, the same results were found. We considered that psychosocial intervention had beneficial effects for subjects with very mild Alzheimer disease.

*Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine; †Tajiri SKIP Center; and ‡Division of Health Care System Science, Department of Planning for Welfare Programs and Public Policy, Tohoku University Graduate School of Economics, Sendai, Japan.

Received October 24, 2000.

Accepted May 15, 2002.

Address correspondence and reprint requests to Kenichi Meguro, M.D., Ph.D., Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; e-mail:

© 2002 Lippincott Williams & Wilkins, Inc.