Combination benefit of cognitive rehabilitation plus donepezil for Alzheimer's disease patients

Objects: Alzheimer's disease (AD) is one of the most important diseases in aging society, and non-drug therapy might be an alternative therapeutic approach. Thus, we evaluated the add-on effect of cognitive rehabilitation on AD patients under donepezil treatment. Methods: We retrospectively analyzed 55 AD patients with a Mini-Mental State Examination score of 15-25, dividing them into two groups depending on whether they were receiving ambulatory cognitive rehabilitation (group D+R, n=32) or not (group D, n=23) in Kurashiki Heisei Hospital over 1 year. The present cognitive rehabilitation included physical therapy, occupational therapy and speech therapy for 1-2h once or twice a week. Results: Between groupD and groupD+R, there was no significant difference in baseline data, such as age, Mini-Mental State Examination score, periventricular hyperintensity on magnetic resonance imaging, deep white matter hyperintensity on magnetic resonance imaging or donepezil dose (4.1mg/day). At 1 year later, however, the Mini-Mental State Examination score improved only in group D+R from 21.7 to 24.0 (**P<0.001), whereas that of groupD remained at 21.5 with both groups of donepezil 5.0mg/day. Conclusion: The combination of cognitive rehabilitation plus a choline esterase inhibitor donepezil showed a better effect for the cognitive function of AD patients than drug only therapy at 1 year.