Journal Mobile Options
Table of Contents
Vol. 35, No. 5-6, 2013
Issue release date: May 2013
Dement Geriatr Cogn Disord 2013;35:300-312

Efficacy of Short-Term Inpatient Rehabilitation for Dementia Patients and Caregivers: Prospective Cohort Study

Schiffczyk C. · Romero B. · Jonas C. · Lahmeyer C. · Müller F. · Riepe M.W.
aDivision of Mental Health and Old Age Psychiatry, Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, bAlzheimer Therapiezentrum Bad Aibling, Bad Aibling, and cPrivate Practice, Berlin, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background/Aims: The efficacy of nonpharmacological and multicomponent treatments in patients with dementia is under discussion, as is the ongoing debate which endpoints best measure efficacy. Methods: 194 dyads of dementia patients and their proxies interested in a combined short-term inpatient rehabilitative treatment were assessed in the patients' homes. Results: Analysis showed that cognition in male patients (cognitive part of the Alzheimer's Disease Assessment Scale: p = 0.048) and depressive mood in female patients were improved after treatment at the 3-month follow-up (Geriatric Depression Scale: p = 0.030). Moreover, the burden on male caregivers was reduced (behavioral pathology in Alzheimer's Disease Rating Scale: p = 0.002) at 3 months. Conclusion: Combined short-term rehabilitative treatment of patients and psychosocial intervention for caregivers is modestly effective in patients with dementia and their caregivers, but may be subject to gender-specific effects.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Erkinjuntti T, Ostbye T, Steenhuis R, Hachinski V: The effect of different diagnostic criteria on the prevalence of dementia. N Engl J Med 1997;337:1667-1674.
  2. Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 2000;157:708-714.
  3. Bruce JM, McQuiggan M, Williams V, Westervelt H, Tremont G: Burden among spousal and child caregivers of patients with mild cognitive impairment. Dement Geriatr Cogn Disord 2008;25:385-390.
  4. Mohamed S, Rosenheck R, Lyketsos CG, Schneider LS: Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. Am J Geriatr Psychiatry 2010;18:917-927.
  5. Lanctot KL, Herrmann N, Yau KK, Khan LR, Liu BA, LouLou MM, Einarson TR: Efficacy and safety of cholinesterase inhibitors in Alzheimer's disease: a meta-analysis. CMAJ 2003;169:557-564.
  6. Winblad B, Jones RW, Wirth Y, Stoffler A, Mobius HJ: Memantine in moderate to severe Alzheimer's disease: a meta-analysis of randomised clinical trials. Dement Geriatr Cogn Disord 2007;24:20-27.
  7. Sitzer DI, Twamley EW, Jeste DV: Cognitive training in Alzheimer's disease: a meta-analysis of the literature. Acta Psychiatr Scand 2006;114:75-90.
  8. Olazaran J, Reisberg B, Clare L, Cruz I, Pena-Casanova J, Del ST, Woods B, Beck C, Auer S, Lai C, Spector A, Fazio S, Bond J, Kivipelto M, Brodaty H, Rojo JM, Collins H, Teri L, Mittelman M, Orrell M, Feldman HH, Muniz R: Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dement Geriatr Cogn Disord 2010;30:161-178.
  9. Buschert VC, Friese U, Teipel SJ, Schneider P, Merensky W, Rujescu D, Moller HJ, Hampel H, Buerger K: Effects of a newly developed cognitive intervention in amnestic mild cognitive impairment and mild Alzheimer's disease: a pilot study. J Alzheimers Dis 2011;25:679-694.

    External Resources

  10. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De VM, Mountain G, O'Connell M, Harrison J, Vasse E, Droes RM, Orrell M: A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 2008;12:14-29.
  11. Takai M, Takahashi M, Iwamitsu Y, Ando N, Okazaki S, Nakajima K, Oishi S, Miyaoka H: The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life. Arch Gerontol Geriatr 2009;49:e1-e5.
  12. Valimaki TH, Vehvilainen-Julkunen KM, Pietila AM, Pirttila TA: Caregiver depression is associated with a low sense of coherence and health-related quality of life. Aging Ment Health 2009;13:799-807.
  13. Matsumoto N, Ikeda M, Fukuhara R, Shinagawa S, Ishikawa T, Mori T, Toyota Y, Matsumoto T, Adachi H, Hirono N, Tanabe H: Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community. Dement Geriatr Cogn Disord 2007;23:219-224.
  14. Romero B, Wenz M: Self-maintenance therapy in Alzheimer's disease. Neuropsychol Rehabil 2001;11:333-355.
  15. Romero B, Wenz M: Concept and effectiveness of a treatment program for patients with dementia and their relatives. Results from the Bad Aibling Alzheimer Disease Therapy Center (in German). Z Gerontol Geriatr 2002;35:118-128.
  16. Chu P, Edwards J, Levin J, Thompson J: The use of clinical case management for early stage Alzheimer's patients and their families. Am J Alzheimers Dis Other Demen 2000;15:284-292.

    External Resources

  17. Chien WT, Lee YM: A disease management program for families of persons in Hong Kong with dementia. Psychiatr Serv 2008;59:433-436.
  18. Grasel E, Wiltfang J, Kornhuber J: Non-drug therapies for dementia: an overview of the current situation with regard to proof of effectiveness. Dement Geriatr Cogn Disord 2003;15:115-125.
  19. Coen RF, O'Boyle CA, Coakley D, Lawlor BA: Individual quality of life factors distinguishing low-burden and high-burden caregivers of dementia patients. Dement Geriatr Cogn Disord 2002;13:164-170.
  20. Romero B: Selbsterhaltungstherapie: Konzept, klinische Praxis und bisherige Ergebnisse. Z Psychol 2004;17:119-134.
  21. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state'. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
  22. Mohs RC, Rosen WG, Davis KL: The Alzheimer's disease assessment scale: an instrument for assessing treatment efficacy. Psychopharmacol Bull 1983;19:448-450.
  23. Lezak M: Neuropsychological Assessment, ed 3. New York, Oxford University Press, 1995.
  24. Beinhoff U, Hilbert V, Bittner D, Gron G, Riepe MW: Screening for cognitive impairment: a triage for outpatient care. Dement Geriatr Cogn Disord 2005;20:278-285.
  25. Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E, Georgotas A: Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. J Clin Psychiatry 1987;48(suppl):9-15.
  26. Burke WJ, Roccaforte WH, Wengel SP: The short form of the Geriatric Depression Scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol 1991;4:173-178.
  27. Burke WJ, Nitcher RL, Roccaforte WH, Wengel SP: A prospective evaluation of the Geriatric Depression Scale in an outpatient geriatric assessment center. J Am Geriatr Soc 1992;40:1227-1230.
  28. Burke WJ, Houston MJ, Boust SJ, Roccaforte WH: Use of the Geriatric Depression Scale in dementia of the Alzheimer type. J Am Geriatr Soc 1989;37:856-860.
  29. Hindmarch I, Lehfeld H, de Jongh P, Erzigkeit H: The Bayer Activities of Daily Living Scale (B-ADL). Dement Geriatr Cogn Disord 1998;9(suppl 2):20-26.
  30. Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179-186.
  31. Logsdon RG, Gibbons LE, McCurry SM, Teri L: Assessing quality of life in older adults with cognitive impairment. Psychosom Med 2002;64:510-519.
  32. Thorgrimsen L, Selwood A, Spector A, Royan L, de Madariaga LM, Woods RT, Orrell M: Whose quality of life is it anyway? The validity and reliability of the Quality of Life-Alzheimer's Disease (QoL-AD) scale. Alzheimer Dis Assoc Disord 2003;17:201-208.
  33. Revell AJ, Caskie GI, Willis SL, Schaie KW: Factor structure and invariance of the Quality of Life in Alzheimer's Disease (QoL-AD) scale. Exp Aging Res 2009;35:250-267.
  34. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, de Vugt M, Mountain G, O'Connell M, Harrison J, Vasse E, Droes RM, Orrell M, INTERDEM Group: A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 2008;12:14-29.
  35. Onder G, Zanetti O, Giacobini E, Frisoni GB, Bartorelli L, Carbone G, Lambertucci P, Silveri MC, Bernabei R: Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial. Br J Psychiatry 2005;187:450-455.
  36. Kurz A, Wilz G: Carer burden in dementia: origins and intervention (in German). Nervenarzt 2011;82:336-342.
  37. Callahan CM, Boustani MA, Unverzagt FW, Austrom MG, Damush TM, Perkins AJ, Fultz BA, Hui SL, Counsell SR, Hendrie HC: Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. JAMA 2006;295:2148-2157.
  38. Perneczky R, Drzezga A, Diehl-Schmid J, Li Y, Kurz A: Gender differences in brain reserve: an (18)F-FDG PET study in Alzheimer's disease. J Neurol 2007;254:1395-1400.
  39. Barnes LL, Wilson RS, Bienias JL, Schneider JA, Evans DA, Bennett DA: Sex differences in the clinical manifestations of Alzheimer disease pathology. Arch Gen Psychiatry 2005;62:685-691.
  40. Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ, McCormick W, Larson EB: Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA 2003;290:2015-2022.
  41. Olazaran J, Muniz R, Reisberg B, Pena-Casanova J, Del Ser T, Cruz-Jentoft AJ, Serrano P, Navarro E, Garcia de la Rocha ML, Frank A, Galiano M, Fernandez-Bullido Y, Serra JA, Gonzalez-Salvador MT, Sevilla C: Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. Neurology 2004;63:2348-2353.
  42. Chapman SB, Weiner MF, Rackley A, Hynan LS, Zientz J: Effects of cognitive-communication stimulation for Alzheimer's disease patients treated with donepezil. J Speech Lang Hear Res 2004;47:1149-1163.
  43. Teri L, Logsdon RG, Uomoto J, McCurry SM: Behavioral treatment of depression in dementia patients: a controlled clinical trial. J Gerontol B Psychol Sci Soc Sci 1997;52:159-166.
  44. Ulstein ID, Sandvik L, Wyller TB, Engedal K: A one-year randomized controlled psychosocial intervention study among family carers of dementia patients - effects on patients and carers. Dement Geriatr Cogn Disord 2007;24:469-475.
  45. Ott BR, Tate CA, Gordon NM, Heindel WC: Gender differences in the behavioral manifestations of Alzheimer's disease. J Am Geriatr Soc 1996;44:583-587.
  46. Riepe MW, Ibach B: Neurological and psychiatric practitioners' views on Alzheimer's disease and treatment thereof. Dement Geriatr Cogn Disord 2008;26:541-546.
  47. Schoenmakers B, Buntinx F, Delepeleire J: Supporting the dementia family caregiver: the effect of home care intervention on general well-being. Aging Ment Health 2010;14:44-56.
  48. Gallicchio L, Siddiqi N, Langenberg P, Baumgarten M: Gender differences in burden and depression among informal caregivers of demented elders in the community. Int J Geriatr Psychiatry 2002;17:154-163.
  49. Harwood DG, Barker WW, Cantillon M, Loewenstein DA, Ownby R, Duara R: Depressive symptomatology in first-degree family caregivers of Alzheimer disease patients: a cross-ethnic comparison. Alzheimer Dis Assoc Disord 1998;12:340-346.
  50. Schiffczyk C, Jonas C, Lahmeyer C, Muller F, Riepe MW: Gender-dependence of substituted judgment on quality of life in patients with dementia. BMC Neurol 2011;11:118.
  51. Corcoran MA: Gender differences in dementia management plans of spousal caregivers: implications for occupational therapy. Am J Occup Ther 1992;46:1006-1012.
  52. Lutzky SM, Knight BG: Explaining gender differences in caregiver distress: the roles of emotional attentiveness and coping styles. Psychol Aging 1994;9:513-519.
  53. Borden W, Berlin S: Gender, coping, and psychological well-being in spouses of older adults with chronic dementia. Am J Orthopsychiatry 1990;60:603-610.
  54. Pruchno RA, Resch NL: Husbands and wives as caregivers: antecedents of depression and burden. Gerontologist 1989;29:159-165.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50