MAXCOG: Maximising Cognition
An individualised information resource for people with mild cognitive impairment and early dementia
In 2010, 12 information handouts were developed to be utilised by specialist health professionals working with clients with mild cognitive impairment (MCI) or early dementia. Our team obtained a small grant from the Wicking Trust in order to be able to develop this tool. The content of the handouts is based on findings from the literature and clinical expertise and qualitative feedback from Monash Health staff, the Victorian Government Department of Human Services, Memory Clinic Coordinators, clients, and family supporters. The tool is designed so that it can be specifically tailored to the needs of individuals. In other words, clinicians can pick and choose which handouts are most suitable for their clients. The aim is to facilitate early intervention and support with minimal use of diagnostic labels. The handouts cover cognitive, psychosocial, and practical management strategies.
Ten years on, in 2020, we have recently updated this resource and the new versions are available here:
- Adjusting to thinking and memory difficulties [PDF 570KB]
- Basic tips for improving memory and concentration [PDF 408KB]
- Your health & lifestyle: Is it impacting on your thinking and memory? [PDF 598KB]
- Focusing attention and avoiding distractions [PDF 340KB]
- Getting organised and solving problems [PDF 474KB]
- Managing language problems [PDF 523KB]
- Managing visual processing difficulties [PDF 572KB]
- Mental techniques to enhance your memory [PDF 576KB]
- Normal ageing: What happens to our thinking and memory [PDF 647KB]
- Supporting someone with thinking and memory difficulties [PDF 567KB]
- Key strategies to improve your memory and thinking [PDF 336KB]
- Using aids to improve your day-to-day memory [PDF 557KB]
Chief Investigator: Dr Bridget Regan
Project Officer: Laura Varanelli
Co-investigators: Dr Colleen Doyle, Professor Yvonne Wells & Professor Glynda Kinsella
Graphic Designer: Karen Rumley (ID Yours)
Editor: Mary Caruana
The project, officially titled 'An individualised information resource for people with Mild Cognitive Impairment and Early Dementia', was funded by the J. O. & J. R. Wicking Trust.
Other organisations that contributed to the development of the handouts include the Australian Psychological Society College of Clinical Neuropsychologists, Eastern Health, and Monash Health.
Key references include:
- Clare, L. (2015). Neuropsychological rehabilitation and people with dementia. Hove, East Sussex: Psychology Press.
- Kinsella, G. J., Ames, D., Storey, E., Ong, B., Pike, K. E., Saling, M. M., . . . & Rand, E. (2016). Strategies for improving memory: A randomized trial of memory groups for older people, including those with mild cognitive impairment. Journal of Alzheimer's Disease, 49(1), 31-43.
- Moniz-Cook, E., & Manthorpe, J. (2009). Early psychosocial interventions in dementia: Evidence based practice. London: Jessica Kingsley Publishers, 2009.
- Unkenstein, A. (2019). Memorywise: How memory works and what to do when it doesn’t. NSW: Allen & Unwin.
- Stuss, D., Winocur, G., & Robertson, I.(eds.) (2010). Cognitive Neurorehabiliation: Evidence and Application – 2nd ed. London: Cambridge University Press.
- Valenzuela, M. J. (2009). It’s never too late to change your mind: The latest medical thinking on what you can do to avoid dementia. Sydney: ABC books.
In 2010 we conducted a formal evaluation of the usefulness of the new information resource in a controlled group trial with clients and family carers from the Kingston Cognitive Dementia and Memory Service (CDAMS) in Melbourne.
We compared 40 clients and family supporters who received ‘service as usual’ with 40 clients and family supporters who received ‘service as usual’ plus the new information resource.
Telephone interviews, comprising open questions, ratings and a quality-of-life questionnaire, were undertaken two-to-four weeks after the client’s final feedback session. We found that the two groups (equivalent on sex, age and cognition) showed a similar pattern of responses regarding handout use and evaluation. However, family supporters in the group who received and read the new resource were better able to describe their use of cognitive management strategies.We concluded that the MAXCOG handouts raised awareness of practical strategies to mitigate memory difficulties particularly for family supporters. Therefore, we recommended that such resources be made available to supporters of people with mild cognitive impairment and early dementia.
Please see the following article for further information regarding the evaluation:
Regan, B., & Wells, Y. (2017). Effectiveness of the maximising cognition (MAXCOG) information resource for clients with mild cognitive impairment and their families. Australasian Journal of Ageing, 37(1), E29-E32.
Since then we have gone onto develop a new goal directed, four-session, face-to-face intervention designed to assist people with MCI/early dementia to learn and apply cognitive management strategies in day-to-day life.
The intervention was implemented and evaluated in a randomised controlled trial (n = 40), using a real-world clinical team with counsellors co-opted from Dementia Australia.
The study demonstrated that people who received the intervention were more likely than the control group to report increases in goal performance and satisfaction.
Two further qualitative studies were able to show improvements in psychological wellbeing and quality of life as well, for at least a subgroup of participants.
Please see the following articles for further information:
Regan, B., Wells, Y., Farrow, M., O’Halloran, P., & Workman, B. (2017). MAXCOG- Maximising Cognition: A randomised controlled trial of the efficacy of goal oriented cognitive rehabilitation for people with mild cognitive impairment and early dementia. American Journal of Geriatric Psychiatry, 5(3), 258-69.
Regan, B., & Wells, Y (2017). ‘Most Significant Change’ and the maximising cognition (MAXCOG) intervention: The views of clients, supporters and counsellors. Australasian Journal of Ageing, 36(4), 324-326.
Regan, B., Wells, Y. & O’Halloran, P. (2019). “I’m more aware now”: Perspectives from people with Mild Cognitive Impairment (MCI), supporters and counsellors about the MAXCOG cognitive rehabilitation intervention. Aging & Mental Health, 24(6), 965-970. DOI: 10.1080/13607863.2019.1574712