The aim of the present report is to investigate possible impacts of cognitive and multisensory
stimulation on the performances of institutionalized and community people in the mini-mental
state examination (MMSE) and in language tests. Subjects were divided in two groups paired
by years of school and age: 1) institutionalized (n = 25, 76.0 ± 6.9 years old) which inhabit in
long-stay institutions and 2) non-institutionalized (n = 17, 74.2 ± 4.0 years old) which inhabit
in the community with their families. MMSE was applied to select cognitively healthy
volunteers which were subsequently submitted to the stimulation and neuropsychological and
language assessments. MMSE and specific language tests, including Boston naming, semantic
(VSF) and phonological (PSF) verbal fluencies, Montreal Communication Evaluation Battery
(MAC) and the Boston cookie theft picture description task were done. The multisensory and
cognitive intervention was applied in groups of 10 volunteers submitted to a series of
stimulation sessions twice a week, over six months in a total of 48 sessions. Sessions were
based on language and memory exercises, visual, olfactory and auditory stimulus, as well as
ludic activities including music, sing and dance. Both groups were assessed at the beginning
(before interventions), in the middle (after 24 sessions) and at the end (after 48 sessions) of
intervention. As compared to the non-institutionalized (community) group, the
institutionalized one showed lower performances in all tasks in all time windows. Each
patient was compared with himself using a contrast index (C) that was designed to be able to
express performances of all tests in a single (0 -1) scale of cognitive performances. The
contrast index was estimated as follow: (C = (D – A) / (D + A), where D corresponds to the
scores before stimulation and A after stimulation). All patients improve their performances
after intervention and the impact was significantly higher in the institutionalized group. We
suggest that the impoverished environment where institutionalized people live is contributing
to the lower cognitive scores observed at the first assessment and by the higher impact of the
stimulation program in this group. As compared to the classic MMSE neuropsychological
test, language tests seem to be much significantly more sensitive to detect early changes in the
cognitive status. Taken together the results may have implications for public health policies
dedicated to the aged population.
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