Age is a major risk factor for the development of cognitive disorders and neurodegenerative pathologies. Cognitive disorders during the phases of bipolar disease are known to exist, and alterations increase significantly after the age of 65. Drug treatments seem to have only a limited effect. A cognitive stimulation program has proven his benefit to patients over 65 with neurodegenerative diseases (Israel, 2004). We propose to evaluate this cognitive stimulation program that we have adapted to bipolar disease.
Bipolar disorders, which belong to the category of mood disorders, are the 6th leading cause of disability in the world. Cognitive disorders are known to exist during the phases of bipolar disease, and alterations increase significantly after the age of 65. Recent studies have shown that attention, memory and executive function impairments are the main causes of cognitive disorders. Residual symptoms have a significant impact on the risk of relapse into bipolar disorder and on quality of life. Cognitive stimulation (CS) is a pedagogical approach based on the idea that cognitive skills contribute to personal development in the same way as psychological and social factors. This study aims at assessing a cognitive stimulation program initially developed for patients with neurodegenerative diseases, and adapted to bipolar disease. This program will be compared to the usual practice consisting in consultation with psychiatrist and sometimes in intervention of home nurses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
40
Patients participate in one session per week according to the following schedule: * 2 sensory stimulation sessions: identify sensations, emotions, how to manage them. * 2 sessions on association, verbal fluency, and imagination: language as a tool for expression in the face of illness. * 2 voluntary attention sessions: improve daily attention. * 2 sessions of intellectual structuring: stimulating and maintaining memory, carrying out external activities. * 2 sessions of structuring through language: impact on social life. * 2 sessions stimulating the temporal and spatial landmarks: agenda, daily trips.
Groupe Hospitalier de la Rochelle Ré Aunis
La Rochelle, France
RECRUITINGScore at the Frontal Assessment Battery (FAB)
The FAB assesses conceptualization (category responses, such as "in what way are a banana and an orange are alike?"), lexical fluency, programming or motor series (Luria), sensitivity to interference (conflicting instructions, such as "tap twice when I tap once"), inhibitory control (Go/No-Go), and environmental autonomy (prehension behavior, such as "do not take my hands")
Time frame: at 3 months after inclusion
Score at FAB
Scores between the 3-month and 6-month evaluation will determine whether executive analysis functions have been maintained
Time frame: at 6 months after inclusion
Number of patients with a positive difference between the scores on the Functional Activities Questionnaire (QAF)
The QAF allows to quickly assess a patient's functional capacity and to identify a functional decline in the patient with a mild neurocognitive disorder, Alzheimer's disease or other neurocognitive disorder.
Time frame: at inclusion
Number of patients with a positive difference between the scores on the Functional Activities Questionnaire (QAF)
A positive difference in scores reflects an improvement in patient autonomy
Time frame: at 6 months after inclusion
Score at delayed matching-to-sample (DMS48)
The DMS48 is a test of visual recognition memory test
Time frame: at inclusion
Score at DMS48
The DMS48 is a test of visual recognition memory test
Time frame: at 3 months after inclusion
Time in minutes at the Trail Making Test A (TMTA)
Evaluation of speed of processing.
Time frame: at inclusion
Time in minutes at the Trail Making Test A
Evaluation of speed of processing.
Time frame: at 3 months after inclusion
Number of errors at Trail Making Test B (TMTB)
Evaluation of mental flexibility
Time frame: at inclusion
Number of errors at Trail Making Test B (TMTB)
Evaluation of mental flexibility
Time frame: at 3 months after inclusion
Score at ISAAC test
Measures fluence
Time frame: at inclusion
Score at ISAAC test
Measures fluence
Time frame: at 3 months after inclusion
Score at Montreal Cognitive Assessment (MMS)
Assessment for detecting cognitive impairment
Time frame: at inclusion
Score at Montreal Cognitive Assessment (MMS)
Assessment for detecting cognitive impairment
Time frame: at 6 months after inclusion
Score at the Hamilton Depression Rating Scale
Evaluation of patient thymic state
Time frame: at inclusion
Score at the Hamilton Depression Rating Scale
Evaluation of patient thymic state
Time frame: at 6 months after inclusion
Interference score at the Stroop test
Evaluation of selective attention
Time frame: at inclusion
Interference score at the Stroop test
Evaluation of selective attention
Time frame: at 6 months after inclusion
Number of hospitalization due to relapse
hospitalization due to relapse
Time frame: at 6 months after inclusion
Score at Zarit scale (caregiver)
Identification of suffering or exhaustion, anxiety and/or depressive disorder(s), sleep disorder(s), etc. in the caregiver
Time frame: at inclusion
Score at Zarit scale (caregiver)
Identification of suffering or exhaustion, anxiety and/or depressive disorder(s), sleep disorder(s), etc. in the caregiver
Time frame: at 6 months after inclusion
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