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Br J Psychiatry. 2005 Nov;187:450-5.

Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial.

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1
Department of Gerontology, Geriatrics and Psychiatry, Catholic University, Rome. graziano_onder@rm.unicatt.it

Abstract

BACKGROUND:

Reality orientation therapy combined with cholinesterase inhibitors has not been evaluated in patients with Alzheimer's disease.

AIMS:

To perform such an evaluation.

METHOD:

We randomly assigned 79 of 156 patients treated with donepezil to receive a reality orientation programme. Caregivers of the treatment group were trained to offer the programme at home 3 days a week, 30 min/day, for 25 consecutive weeks, and were invited to stimulate and involve patients in reality-based communication.

RESULTS:

The treatment group showed a slight improvement in Mini-Mental State Examination (MMSE) scores (mean change +0.2, s.e.=0.4) compared with a decline in the control group (mean change -1.1, s.e.=0.4; P=0.02). Similarly for the Alzheimer's Disease Assessment Scale--Cognition (treatment group mean change +0.4, s.e.=0.8; control group -2.5, s.e.=0.8; P=0.01). The intervention had an equal effect on cognition in those with mild (MMSE score > or = 20) and moderate (score <20) dementia. No significant effect was observed for behavioural and functional outcomes.

CONCLUSIONS:

Reality orientation enhances the effects of donepezil on cognition in Alzheimer's disease.

PMID:
16260821
DOI:
10.1192/bjp.187.5.450
[Indexed for MEDLINE]
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