Relational Training Intervention as add-on therapy to current specific treatments in patients with mild-to-moderate Alzheimer’s disease.

Objective: The study was performed to evaluate the efficacy of a computer assisted multiple-exemplar relational training (RFT), as add-on non-pharmacological therapy to cholinesterase inhibitors (ChEIs) in patients with mild-to-moderate Alzheimer’s disease (AD). Materials and methods: This was a prospective, randomized, 3 month, parallel-group study comparing ChEIs + RFT vs ChEIs. Participants were exposed to multiple exemplar training across several sessions for 3 months. Training was conducted for one hour weekly. Cognitive and executive functions were assessed cross-sectionally at baseline, and at the end of training (3 months) using respectively MODA, Coloured Progressive (CPM) and attentive matrices (AM). Results: 29 patients (16, 55,2% female and 13,44,8% male) were enrolled and 26 patients completed the evaluation. Three patients withdraw for loss of compliance. Mean age was 77,88 (+ 7,97), mean education was 5,22 (+2,79) years. The MODA scores for the group with additional RFT therapy showed a mean improvement of +6,42 points versus baseline where the group in drug monotherapy showed a mean worsening of -1,06 points. The MODA scores for combination therapy differed significantly from baseline (p> 0.05) and between-group (p>0.05) in favour of the RFT add-on therapy. CPM scores for combination therapy showed a mean improvement versus baseline of +2 points compared to pharmacological monotherapy that showed a mean worsening of -0,15 points. AM scores for combination therapy showed a mean improvement versus baseline of +2,85 points compared with monotherapy that showed a mean worsened of -0,69 points. No major side effects of ChEI were reported. Conclusions: The addition of RFT to the current standard treatments for AD may represent a way to prolong on time the beneficial effects of cholinergic therapies.