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A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in alzheimer disease


Thivierge, Stéphanie, Jean, Léonie, Simard, Martine


The American Journal of Geriatric Psychiatry, Volume: 22, No.: 11, Pages.: 1188-1199

Year of Publication



Objective: The goal of the study was to investigate the effectiveness of a memory rehabilitation program to re-learn instrumental activities of daily living (IADLs) in patients with Alzheimer disease (AD). Design: This was a 6-month block-randomized cross-over controlled study. Setting: All evaluation and training sessions were performed at each patient’s home. Participants: Twenty participants with mild to moderate AD. Intervention: The trained IADL was chosen by the patient and his/her caregiver in order to target the patient’s needs and interests. Participants were trained twice a week for 4 weeks with the errorless learning (ELL) and spaced retrieval (SR) cognitive techniques. After training, there were several follow-ups over a period of at least 3 months. Measurements: Performance on the trained IADL was assessed by a Direct Measure of Training (DMT), an observational instrument adapted from a well-validated scale. General cognitive function, everyday memory functioning, quality of life, neuropsychiatric symptoms and ADL/IADL of patients, as well as the caregiver’s burden were assessed as secondary outcomes. Results: A statistical significant difference was found between the trained and untrained groups on the DMT immediately following the intervention. Improvements were maintained for a 3-month period. The training did not have effects on any other measures. Conclusions: The present study showed that it is possible for AD patients to relearn significant IADLs with the ELL and SR techniques and to maintain these gains during at least 3 months. The findings of this study emphasize the importance to design robust but individualized intervention tailored on patients’ particular needs. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (journal abstract)

Bibtex Citation

@article{Thivierge_2014, doi = {10.1016/j.jagp.2013.03.008}, url = {}, year = 2014, month = {nov}, publisher = {Elsevier {BV}}, volume = {22}, number = {11}, pages = {1188--1199}, author = {St{'{e}}phanie Thivierge and L{'{e}}onie Jean and Martine Simard}, title = {A Randomized Cross-over Controlled Study on Cognitive Rehabilitation of Instrumental Activities of Daily Living in Alzheimer Disease}, journal = {The American Journal of Geriatric Psychiatry} }


activities of daily living, alzheimer disease, alzheimer’s disease, cognitive rehabilitation, daily activities, errorless learning, instrumental activities of daily living, intervention, memory, program, rehabilitation, spaced retrieval

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Behaviour, Carer Burden (instruments measuring burden), Cognition, Quality of Life of Person With Dementia


Extra Care Housing

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Adult safeguarding and abuse detection/prevention