This GP develops a holistic approach of friendly intervention for people in early phases of cognitive decline.
The aim of this initiative is to provide people in early phases of cognitive decline with an intervention which is friendly, easy and with non-secondary effects, to cope with this deterioration. Secondly, the intervention enhances general health and functionality and prevents dependency. Thirdly, it increases the social relationship in this generation promoting wellbeing.
For that purpose, 5 nursing homes in the area of Biscay were contacted and participated together with the University of Deusto in identifying and recruiting the target population. An expert in the field performed a pre-intervention general assessment to define the characteristics of participants in terms of their cognitive and psychological status. When a person accepted to participate (voluntarily), he/she was assigned to either an experimental group or a normal control group. The experimental group was involved in group cognitive retraining with the Rehacop program (designed for this purpose) 3 times a week during 3 months. All the assessments were again implemented at the end of the intervention. The control group was enrolled in occupational tasks (including sports, gardening, and manual dexterity) with the same frequency and duration. After both groups completed the intervention cycle, a statistically significant improvement in the experimental group compared to normal controls in most cognitive domains explored was observed. This improvement was related to functional outcome and level of dependency.
The cost of the program is 124,80 euros for the therapist's manual and 53,80 euros for the patient's manual. To this it is a must add 9 euros of shipping costs. Being the total of 187,60 euros.
Evidence of success
In Parkinson Disease patientes significant differences between REHACOP group and control group in processing speed (0.13[SE=0.07] vs −0.15[SE=0.09], p=0.025), visual memory (0.10[SE=0.10] vs −0.24[SE=0.09], p=0.011), theory of mind (1.00 [SE=0.37] vs −0.27[SE=0.29], p = 0.013), and functional disability (−5.15[SE=1.35] vs 0.53[SE = 1.49], p=0.012) were found. DOI: 10.1212/WNL.0000000000001043
The validation development project involved a big number of stakeholders. It required a very good coordination and management. But the results obtained in the evaluation stage have been a facilitator of the final product development.
Potential for learning or transfer
This GP is based on the principles of restoration, compensation and optimization of cognitive functions. In addition, the effectiveness of the REHACOP program has been demonstrated in people with multiple sclerosis, Parkinson's disease and in normal aging. Due to the highly structured nature of the programme, and its relatively simple implementation, the transference to the public network of health and social services in Spain and the Basque Country would be unproblematic. In order to extend its impact to the rest of Europe, the linguistic translation of the programme is necessary; however, no cultural adaptations are needed.
As a successful and cheap product, it could be implemented in any Health System around the world whiout difficulty.