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Real-World Multimodal Day-Care Intervention for Mild Cognitive Impairment with Lewy Bodies: A Prospective 3-Year
Miyuki Nemoto1, Kiyotaka Nemoto2, Miho Ota1
1Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Introduction:
Mild cognitive impairment with Lewy bodies (MCI-LB) is generally associated with more rapid cognitive decline than mild cognitive impairment due to Alzheimer's disease (MCI-AD). However, evidence regarding the potential cognitive trajectories of individuals with MCI-LB participating in structured non-pharmacological multimodal programs remains limited. The aim of the study was to preliminarily examine cognitive changes over time among individuals with MCI-LB and MCI-AD undergoing a multimodal intervention.
Methods:
Conducted at the University of Tsukuba Hospital between April 2013 and February 2020, this prospective study enrolled 74 participants (MCI-LB: 14; MCI-AD: 60) in the Cognitive Improvement Day-Care (CIDC) program. The CIDC was a multimodal intervention offering structured sessions including physical exercise, cognitive training, music therapy, and art-based activities. Participants attended the program, mostly once a week, and underwent annual cognitive assessments for up to 3 years using the Japanese version of Mini-Mental State Examination (MMSE-J). Linear mixed-effects models were used to analyze longitudinal changes in MMSE-J scores.
Results:
The overall annual cognitive decline was -0.36 points/year (95% CI: -0.63, 0.10). The annual decline was -0.44 points/year (95% CI: -0.95, 0.06) for the MCI-LB group and -0.34 points/year (95% CI: -0.64, -0.03) for the MCI-AD group. No significant group-by-time interaction was observed over the 3-year follow-up (p = 0.97).
Conclusions:
These findings suggest that individuals with MCI-LB exhibited longitudinal cognitive trajectories under a structured multimodal intervention that were comparable to those observed in individuals with MCI-AD, at least as assessed by the MMSE-J. Future studies with larger samples and more detailed cognitive assessments are needed to clarify potential subtype-specific responses.
Insights
Individuals with mild cognitive impairment with Lewy bodies (MCI-LB) showed similar cognitive changes to those with mild cognitive impairment due to Alzheimer's disease (MCI-AD) when participating in a multimodal program. This suggests non-pharmacological interventions may benefit both MCI subtypes.
Area of Science:
- Neurology
- Gerontology
- Cognitive Science
Background:
- Mild cognitive impairment with Lewy bodies (MCI-LB) typically presents with faster cognitive decline than mild cognitive impairment due to Alzheimer's disease (MCI-AD).
- Limited data exists on the long-term cognitive trajectories of MCI-LB patients in structured non-pharmacological multimodal programs.
- Understanding these trajectories is crucial for developing effective interventions.
Purpose of the Study:
- To preliminarily examine and compare cognitive changes over time in individuals with MCI-LB and MCI-AD.
- To assess the impact of a structured multimodal intervention on cognitive trajectories in these patient groups.
- To provide initial insights into potential differences or similarities in response to non-pharmacological treatments.
Main Methods:
- A prospective study was conducted at University of Tsukuba Hospital (April 2013-February 2020).
- 74 participants (14 MCI-LB, 60 MCI-AD) enrolled in the Cognitive Improvement Day-Care (CIDC) program, a multimodal intervention including physical exercise, cognitive training, music, and art therapy.
- Annual cognitive assessments using the Japanese version of the Mini-Mental State Examination (MMSE-J) were performed for up to 3 years, analyzed with linear mixed-effects models.
Main Results:
- The overall annual cognitive decline was -0.36 points/year.
- MCI-LB group showed an annual decline of -0.44 points/year, while the MCI-AD group declined at -0.34 points/year.
- No significant group-by-time interaction was observed over the 3-year follow-up (p=0.97), indicating comparable cognitive trajectories between groups.
Conclusions:
- Individuals with MCI-LB demonstrated longitudinal cognitive trajectories comparable to MCI-AD patients within a structured multimodal intervention, as measured by the MMSE-J.
- These findings suggest that multimodal non-pharmacological programs may yield similar cognitive outcomes for both MCI subtypes.
- Further research with larger cohorts and more detailed cognitive assessments is warranted to confirm these results and explore subtype-specific responses.
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