[Memory training: an important constituent of milieu therapy in senile dementia]

At the Memory Clinic in Basel we provide long-term memory training as part of our "milieu therapy". Mildly demented elderly out-patients attend weekly group sessions of 60 min for a special semistructured memory training. The goal is to relearn and practice strategies which help to preserve or extend the phase of autonomy and thus life quality and self-esteem. In several studies we tested the efficiency of the training on mood, global mental status, short-term memory, cognitive flexibility, and quality of life by comparing the performance of groups of patients attending the memory training to nontreated matched control groups after 1 year. We found that depression scores improved in a treated group and worsened in a control group, independently of diagnosis. Global mental status as measured by Mini-Mental-State Examination and performance on a figural and verbal fluency task remained stable for the memory training groups and declined in the control groups. Short-term memory declined in both groups, however, significantly only in the nontreated groups. The individual quality of life schedule showed stable or improved scores for the treated group and lower scores for the control group. We conjecture from these results that memory training is effective in mildly demented out-patients in delaying the progression of cognitive deficits.