What is the goal of attention intervention for Alzheimer-type dementia?

Maintain attention and slow cognitive decline by using meaningful, graded activities adapted to the user's cognitive status to support performance in ADLs and IADLs.

Which attention deficits appear in early Alzheimer-type dementia?

Early stages show impaired selective attention and divided attention; sustained attention becomes more affected in moderate to severe stages.

How does NeuronUP support neuropsychological rehabilitation for Alzheimer-type dementia?

NeuronUP offers adaptable, targeted exercises with personalization, progressive grading, and multiple delivery formats (paper, tablet, computer) to address specific cognitive deficits.

How is the Word Search activity customized for Alzheimer-type dementia?

Word Search uses personally meaningful words (e.g., family names), starts with a 10×10 grid, seven target words, and increases complexity to boost relevance and engagement.

What does the Copy the Letters activity train for Alzheimer-type dementia?

Copy the Letters trains visual attention and copying skills using a color-coded model grid; the graded task presents a six-by-six grid requiring completion of 20 letters.

What are the Fast Numbers tablet exercise rules for Alzheimer-type dementia?

Fast Numbers requires finding immobile numbers among moving ones across phased levels; five phases per level, return on error, and sessions typically begin at level one for ten minutes.

Intervention with NeuronUP in an Alzheimer’s patient

The following intervention with NeuronUP proposes a series of activities aimed at a specific case of an older adult diagnosed with Alzheimer-type dementia. This dementia is the most common and is characterized as primary, degenerative, and with cortical involvement¹.

In the early stages, users who present cognitive impairment, and specifically in the cognitive process of attention, are affected as follows²:

Impairment in the functioning of selective attention (the ability to direct attention to a relevant stimulus and inhibit other irrelevant ones),
Alterations in divided attention (the ability to attend to two or more relevant stimuli at the same time).
In moderate and severe states, alterations in sustained attention (the ability to maintain the focus of attention for a prolonged time) are observed.

The intervention will be carried out with the web platform NeuronUP³, which pursues neuropsychological rehabilitation and focuses on the affected functional cognitive deficits. Different activities can be used to stimulate the cognitive functions we want, in this case attention. For the intervention of an older adult diagnosed with Alzheimer-type dementia two paper activities and one with the tablet will be used in this case, although a computer could also be used. Exercises will be adapted to the user’s cognitive status.

Through the Framework of the American Occupational Therapy Association⁴, an assessment of the affected performance skills will be carried out: specifically the cognitive skills. After evaluating each of them, an intervention focused on attention is proposed, with the objective of promoting adequate performance in ADLs and IADLs and improving their quality of life.

Objective of the intervention for an older adult diagnosed with Alzheimer-type dementia

The general objective for the intervention of an older adult diagnosed with Alzheimer-type dementia , therefore, will be to maintain attention and prevent deterioration of this cognitive function through activities that are meaningful to the user.

Activities for the NeuronUP intervention for an older adult diagnosed with Alzheimer-type dementia

Word Search

In this activity different words hidden among a set of words will be searched for inside a Word Search. It will be done in a personalized way, and for this reason the hidden words will be related to aspects of their daily life.

In this case the names of their closest family members will be placed. As it can be graded, it will start with a number of 10 rows and 10 columns and will subsequently increase to raise complexity. The number of words can also vary, but it will be a specific number of 7 words for all levels.

Copy the Letters

This activity consists of copying an incomplete grid by looking at a model grid that the platform provides. The letters in both grids have different colors so they are easily recognizable. Thus the letter “A” will always be light blue, and, for example, the letter “P” will be pale pink.

In this activity the grading provided by the program itself will be used in which a grid of six rows by six columns is presented, and where 20 letters in total have to be completed.

NeuronUP Activities - Copy the Letters — NeuronUP activity *Copy the Letters*

Fast Numbers

This is the only activity in which the tablet will be used. It consists of finding as quickly as possible the numbers that remain immobile among a set of numbers in constant motion. The activity consists of several levels subdivided into phases. To advance a level five phases must be passed. If more than three errors are made in the same phase, one will go back to the previous phase.

In the first phases a larger number of immobile numbers appear and in adjacent squares. In contrast, in the more advanced phases there are fewer immobile numbers and they are scattered in the grid, even reaching in the last level a single immobile number. It will start with the first level, and once the five phases are completed, the level will increase, so that we complete 10 minutes of activity.

NeuronUP Activities - Fast Numbers — NeuronUP activity *Fast Numbers*

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Bibliography

Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley’sNeurology in clinical practice. 7th ed. Philadelphia, PA: Elsevier; 2016: chap 95.
Alberca R, López-Pousa S . Alzheimer’s disease and other dementias. 4th ed. Madrid, Médica Panamericana; 2012: chap 13.
NEURONUP. NEURONUP [website]. La Rioja: NEURONUP; 2012 [updated Nov 7, 2016; accessed Nov 7, 2016]. Available at: https://neuronup.com/es
Ávila Álvarez A, Martínez Piédrola R, Matilla Mora R, Máximo Bocanegra M, Méndez Méndez B, Talavera Valberde MA et al. Framework for Occupational Therapy practice: Domain and Process. 2nd Edition [Translation]. www.terapia-ocupacional.com [Internet portal]. 2010 [10/20/2015]; [28p.]. Available at: http://www.terapia-ocupacional.com/aota2010esp.pdf. Translated from American Occupational Therapy Association (2008). Occupational therapy practice framework: Domain and process (2nd ed.).