A Case of Complete Symptom Resolution and Improvement in Cognition in a 71 Year Old Male with Cognitive Decline Following a 1-Week Multi-Modal Neuro-Rehabilitation Program
Background: A 71-year-old male presented with a gradual decline in ability “to think, reason, do work, and remember names of people”. He had also noticed a heightened sense of emotionality, cognitive decline, headaches, and neck stiffness. Graded Symptom Checklist (GSC) severity score was 59/138. Standard Assessment of Concussion (SAC) was scored at 15/30 including decreased orientation, decreased immediate word recall, and absence of delayed word recall. Trails A (TA) and Trails B (TB) had scores of 39.7 sec and 103.2 seconds respectively.
Methods: A five-day, multi-modal program of neurological rehabilitation was administered three times per day, for approximately 45 minutes per session. Each session consisted of electrical somatosensory stimulation, neuromuscular reeducation exercises, vestibular-ocular rehabilitation, off-vertical axis rotation, and eye exercises.
Results: Following the course of treatment, the patient had a complete decrease in GSC severity to a 0/138 (-100%); increased SAC score to 23/30 (+34.8%) with improved immediate recall, delayed recall and full orientation; no change in TA time 40.4 sec, and decreased TB time 68.6 sec (-33.5%).
Conclusion: Short duration, multi-modal, intensive programs of neurological rehabilitation may effectively reduce symptoms, improve orientation, concentration, speed and fluid attention as well as other cognitive abilities of individuals experiencing cognitive decline in the geriatric population. The SAC may also be an effective way to measure pre and post intervention cognitive function in the geriatric population. Further research into high intensity, short- duration, multi-modal neurological rehabilitation for geriatric cognitive decline is indicated.