Home-based rehabilitation program for older adults with cognitive impairment: preliminary results

Background: While there is a growing interest in cognitive rehabilitation for older adults, not enough data is available regarding its feasibility and effectiveness in an older population. The present study implemented a home-based cognitive rehabilitation program for older adults in order to explore the program's feasibility and effectiveness. Methods: The 8-month rehabilitation program consisted of multiple workbooks targeted at improving attention, memory and executive function. Study participants worked on the workbooks at home with family members, while professional cognitive rehabilitation staff periodically evaluated their progress. Attention, memory and executive function were evaluated at outset, at month 4 and at the end of month 8. Results: The nine initial participants had histories of subarachnoid hemorrhage or traumatic brain injury, or were outpatients of a memory clinic who had memory impairment. Six participants (66.7%) completed the 8-month program; one subject intentionally withdrew from the program while two others withdrew due to hospitalization. Among the six remaining participants, attention improved significantly between the month 4 and month 8 evaluations, and between the initial and month 8 evaluations. Within subsets of the attention test, significant improvement was seen in the visual selective attention domain. There was no change in memory or executive function, as well as the subjective difficulties in daily lives. Conclusions: This study suggests that a home-based cognitive rehabilitation program for older adults is feasible and may improve attention, especially visual selective attention. An 8-month rehabilitation program may have been of insufficient duration to generate significant improvements in memory or executive function.