Case Study of Early Onset Dementia of the Alzheimer’s Type
Nico Mulder, Ph.D
Faculty of Behavioral Sciences,
Biological, Developmental & Scientific Basis of Behavior February 26, 2012
This paper reviews the use of cognitive rehabilitation treatment of early stage of dementia Alzheimer’s type. The case study examines a 72 year old male patient diagnosed with early stage dementia of Alzheimer’s Type. This study used visual imagery, as well as cues and expanding rehearsal during the cognitive rehabilitation. The evaluation of cognitive rehabilitation treatment included the psychological, physiological, neurological assessments and self-reports. Results suggested that extended use of cognitive rehabilitation treatment ensued longer lasting improved cognitive functioning. With the results of the study discussed, implications suggest that combining longer treatment of cognitive rehabilitation could help reduce the progression of early onset dementia of the Alzheimer’s Type.
Clare, Wilson, Carter, Hodges, and Adams (2001) studied a 74-year old single man, named “VJ” who lived with his sister in a single case study. VJ was formerly employed in the construction industry. VJ started to attend the memory clinic in 1993. He was then diagnosed having an early stage of dementia of Alzheimer type (DAT). His sister joined him at the clinic. The researchers started with a process called, cognitive rehabilitation (CR) intervention. Cognitive rehabilitation (CR) focuses on memory functioning. Although CR was at first developed for patients with traumatic brain injuries, it was proven to be efficient for people experiencing cognitive difficulties (Savage, 2009, p. 31). In order to define CR, it is necessary to define cognition. Katz and Hadas (1995) quote Lidz in defining cognition, “…as the individual's capacity to acquire and use information to adapt to environmental demands” (p. 29). Sigelman and Rider (2012) say that cognition is, “the activity of knowing and the process through which knowledge is acquired and problems solved” (p. 210). Cognitive rehabilitation is quoted by Katz and Hadas (1995) “…the therapeutic process of increasing or improving an individual's capacity to process and use incoming information so as to allow increased functioning in everyday life, this includes both methods to restore cognitive functioning and compensatory techniques" (p. 29). Interventions aimed in CR are divided into remedial and adaptive/functional strategies (Katz & Hadas, 1995). The main aim of the remedial strategy is the individual's impaired capabilities. The functional strategies are aimed to enhance the strengths of the individual for functioning. The assumption these two strategies are built upon is, “…that functional activities require cognitive perceptual skills…” (Katz & Hadas, 1995, p. 30) and cognitive impairments can be modified and treated in the adult dysfunctional brain which will enhance reorganisation or recovery of the brain. Based on these assumptions the remedial strategy is directed towards functional abilities by retraining perception skill components of behaviour, while the functional strategy in contrast assumes that the affected adult brain has limited recovery potential and that retraining of the brain should be focused on specific activities as required (Katz & Hadas, 1995). The unique feature of all occupational therapy models, are the emphasis that treatment is based on purposeful activities that are analyzed and adapted to the patient's cognitive and functional ability level. This therapy is not without controversy. As the critics of CR indicated, memory training for people with DAT increases frustration for the patients, because the improvement in cognition is short term (Clare et al., 2001). Sigelman and Rider (2012) agree by saying, “…over time, individuals cannot recall...