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Predictors of Neuropsychological Improvement Following Cognitive Rehabilitation in Patients with Gliomas

Published online by Cambridge University Press:  21 December 2010

Karin Gehring*
Affiliation:
CoRPS, Faculty of Social and Behavioural Sciences, Tilburg University, The Netherlands
Neil K. Aaronson
Affiliation:
Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, The Netherlands Department of Clinical Psychology, University of Amsterdam, The Netherlands
Chad M. Gundy
Affiliation:
Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, The Netherlands
Martin J.B. Taphoorn
Affiliation:
Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands Department of Neurology, VU University Medical Center Amsterdam, The Netherlands
Margriet M. Sitskoorn
Affiliation:
CoRPS, Faculty of Social and Behavioural Sciences, Tilburg University, The Netherlands
*Corresponding
Correspondence and reprint requests to: Karin Gehring, PhD, Tilburg University, Prisma Building; Room P 512, P.O. Box 90153, 5000 LE Tilburg, The Netherlands. E-mail: k.gehring@uvt.nl

Abstract

This study investigated the specific patient factors that predict responsiveness to a cognitive rehabilitation program. The program has previously been demonstrated to be successful at the group level in patients with gliomas, but it is unclear which patient characteristics optimized the effect of the intervention at the individual level. Four categories of possible predictors of improvement were selected for evaluation: sociodemographic and clinical variables, self-reported cognitive symptoms, and objective neuropsychological test performance. Hierarchical logistic regression analyses were conducted, beginning with the most accessible (sociodemographic) variables and ending with the most difficult (baseline neuropsychological) to identify in clinical practice. Nearly 60% of the participants of the intervention were classified as reliably improved. Reliable improvement was predicted by age (p = .003) and education (p = .011). Additional results suggested that younger patients were more likely to benefit specifically from the cognitive rehabilitation program (p = .001), and that higher education was also associated with improvement in the control group (p = .024). The findings are discussed in light of brain reserve theory. A practical implication is that cognitive rehabilitation programs should take the patients’ age into account and, if possible, adapt programs to increase the likelihood of improvement among older participants. (JINS, 2011, 17, 256–266)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2010

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