The rise in life expectancy in recent decades has resulted in a dramatic increase in the
population of older people. This has been associated with a rise in the prevalence of
age-associated conditions, particularly cognitive impairment and dementia. The prevalence of
dementia in those older than 65 doubles every five years, and reaches a rate of more than 40%
at age 85 years. Data from the World Health Organization predict 43 million dementia
sufferers globally in the year 2020.
Mild Cognitive Impairment (MCI) is a syndrome comprising cognitive symptoms and impairment
beyond population norms based on age and education, without functional loss. MCI represents a
risk factor for dementia at a rate of conversion of approximately 12% annually. Thus patients
with MCI characterize an important group for possible interventions in preventing further
cognitive decline, particularly physical exercise and cognitive training.
The Feuerstein Program The Feuerstein Instrumental Enrichment (IE) program has been
well-established as an effective intervention in other age groups and clinical situations.
The method's creator, Professor Reuven Feuerstein, postulated that the thinking process is
divided into three major phases - Input, Elaboration and Output - and that in each phase,
different mental functions are at work. The quality of thinking depends upon the way the
different functions are activated in each of the phases. The IE tools enable the correction
or activation of cognitive deficiencies through use of targeted and focused mediation, which
conserves and reinforces cognitive ability.
Recently, the Feuerstein Instrumental Enrichment Program for the Elderly was developed
particularly for older people with cognitive decline.
Instrumental Enrichment can benefit all senior citizens, but is particularly recommended for
those who do not constantly face intellectual challenges.
The process of learning IE is administered in group settings by instructors who have been
trained to specifically mediate to the geriatric population. Work in groups constitutes a
challenging, interesting and gratifying activity. It also appears that beyond contributing to
the conservation and improvement of cognition, participating in the program may also have the
effect of increasing feelings of competence, independence and improved emotional state.
15 subjects conforming to inclusion and exclusion criteria with a known clinical diagnosis of
MCI and who provide informed consent will undergo cognitive and functional assessment to
confirm the diagnosis of MCI. Baseline assessment using the Mindstreams Mild Cognitive
Impairment Computerized Assessment Battery will be performed. Subjects will then participate
30 twice weekly meetings of 90 minutes duration each (for a total of 15 weeks). Mindstreams
testing will be repeated after 15 sessions and at completion of the study.
