Authors (including presenting author) :
Cheung HY(1), Ma SY(1), Lee ML(1), Leung WY(1), Wu A(1)
Affiliation :
(1)Department of Occupational Therapy, Caritas Medical Centre, Hong Kong
Introduction :
People with cognitive impairment experienced decline in cognitive function which interfere their independence in activities of daily living. An occupational therapist-led cognitive training program has been provided to this group of patients from March 2017 to July 2019. A randomised controlled trial study (RCT) was conducted.
Objectives :
This RCT aimed to evaluate the effectiveness of the occupational therapist-led cognitive training program for patients with cognitive impairment.
Methodology :
Patients referred for cognitive rehabilitation in out-patient unit of Occupational Therapy Department were recruited. The program including cognitive games designed by Occupational Therapist, education and practice of memory strategies, and home program was provided. Pre- and post- Montreal Cognitive Assessment (Hong Kong Version) (HK-MoCA) were conducted by independent assessors as outcome measures. Satisfaction survey for participants and their caregivers were conducted.
Result & Outcome :
30 patients were recruited and divided into control group (N=15) and experimental group (N=15) randomly. There were more women (76.7%) than men (23.3%). There was no significant difference in age (p=0.547) and year of education (p=0.883) between experimental group and control group. The mean age of patients in control group and experimental group were 82.07 and 80.13 respectively. The mean year of education of patients in control group was 4.07 and experimental group was 3.80. No significant difference in the pre-HKMoCA between two groups (p=0.543) but the post-HKMoCA of experimental group was significantly higher than control group when analysed with Mann-Whitney U test (p=0.015). With further analysis of the individual domain in the post-HK-MoCA with Mann-Whitney U test, significant improvement in orientation (p=0.002) and total number of retrieved item (p=0.028) were shown in experimental group. An improving trend in total number of encoding items was also noted after the cognitive training program. The percentage of patients with post-HK-MoCA below 2nd percentile cut-off in the experimental group decreased significantly from 80% to 33.3% (p=0.003). In the satisfaction survey, 90% of the patients and all caregivers agreed there was improvement in memory after the program. 86% of the caregivers would apply the skills learnt from the program in daily caring.
The occupational therapist-led cognitive training program was effective for patients with cognitive impairment. Positive feedback was gained from both the patients and the caregivers. Further study of the effectiveness of the cognitive training program on other cognitive domains can be evaluated with a larger sample size.