Abstract
BACKGROUND: Cognitive decline in dementia often leads to impaired activities of daily living (ADL), which worsens as the condition progresses. Although a complex rehabilitation program that includes exercise, cognitive tasks, and family guidance improves physical ability in people with dementia and mild cognitive impairment (MCI), the effects on cognitive function and ADL remain unclear. We conducted this study to clarify this point. METHODS: This retrospective observational study was conducted at the outpatient rehabilitation department of the National Center for Geriatrics and Gerontology, Japan. It analyzed 50 MCI and Alzheimer disease (AD) patients who participated in a holistic physico-cognitive rehabilitation (HPCR) program. The control group consisted of 50 patients matched by age, gender, disease, and Barthel Index (BI) from 963 MCI and AD patients who did not undergo HPCR. Cognitive function was assessed using the Mini-Mental State Examination, and ADL was evaluated with the BI. RESULTS: Both groups showed a significant decline in MMSE scores after 1 year. However, the intervention group maintained its ADL function, while the control group experienced a significant reduction in BI scores. CONCLUSION: HPCR, combining exercise therapy and cognitive training, may help maintain ADL in patients with MCI and AD despite cognitive decline. This study suggests that rehabilitation plays a crucial role in sustaining daily functioning in dementia care.