[Cognitive rehabilitation--the learning therapy for the senile dementia]

The conventional cognitive rehabilitation was the technique for the patients with the neuropsychological disorders such as aphasia, apraxia, agnosia, attentional disorder, memory impairment, and executive function disorder. These disorders were induced by the organic brain damages due to the traumatic brain injury or the stroke. The aim of the conventional cognitive rehabilitation was to recover their impaired function and improve their quality of life. Recently, subjects of cognitive rehabilitation were not only the patients with the organic brain damages but also the patients with the functional brain impairment including a dementia. Kawashima et al. developed "The learning therapy" as a cognitive rehabilitation for the senile dementia through the top-down approach, the concept of which was derived from the knowledge of the functional brain imaging. The learning therapy is defined as a training of simple arithmetic calculation and reading aloud communicating with a trainer. The effect of The learning therapy is to keep and improve the prefrontal function including cognitive function, ability of communication and independence. It was confirmed that The learning therapy was an effective cognitive rehabilitation for the senile dementia patients by improving their prefrontal function. The effect of prevention against dementia is also being studied. Furthermore, we propose a new educational program for the cognitive development disorders to improve their prefrontal functions.