Cognitive stimulation therapy (CST): neuropsychological mechanisms of change

2012 ◽  
Vol 25 (3) ◽  
pp. 479-489 ◽  
Author(s):  
Louise Hall ◽  
Martin Orrell ◽  
Joshua Stott ◽  
Aimee Spector

ABSTRACTBackground: Cognitive stimulation therapy (CST) is an evidence-based psychosocial intervention for people with dementia consisting of 14 group sessions aiming to stimulate various areas of cognition. This study examined the effects of CST on specific cognitive domains and explored the neuropsychological processes underpinning any effects.Methods: A total of 34 participants with mild to moderate dementia were included. A one-group pretest–posttest design was used. Participants completed a battery of neuropsychological tests in the week before and after the manualised seven-week CST programme.Results: There were significant improvement pre- to post-CST group on measures of delayed verbal recall (WMS III logical memory subtest – delayed), visual memory (WMS III visual reproduction subtest – delayed), orientation (WMS III information and orientation subscale), and auditory comprehension (Token Test). There were no significant changes on measures of naming (Boston Naming Test-2), attention (Trail Making Test A/Digit Span), executive function (DKEFS verbal fluency/Trail Making Test B), praxis (WMS III visual reproduction – immediate) or on a general cognitive screen (MMSE).Conclusions: Memory, comprehension of syntax, and orientation appear to be the cognitive domains most impacted by CST. One hypothesis is that the language-based nature of CST enhances neural pathways responsible for processing of syntax, possibly also aiding verbal recall. Another is that the reduction in negative self-stereotypes due to the de-stigmatising effect of CST may impact on language and memory, domains that are the primary focus of CST. Further research is required to substantiate these hypotheses.

2017 ◽  
Vol 87 (2) ◽  
pp. 124-140 ◽  
Author(s):  
Małgorzata T. Piskunowicz ◽  
Katarzyna Linkowska ◽  
Szymon Gołota ◽  
Tomasz Grzybowski ◽  
Kornelia Kędziora-Kornatowska ◽  
...  

The ε4 allele of the apolipoprotein E (APOE) gene is known as a risk factor for dementia. How APOE ε polymorphism affects cognitive performance in nondemented aging subjects remains less clear. In this study, the relationship between APOE status and cognitive performance across various cognitive domains in adults aged 55 to 75 years ( n = 74) without dementia was investigated. E4 carriers ( n = 11) performed worse versus noncarriers on forward Digit Span and delayed recall of the Rey-Osterrieth complex figure. General linear model analysis revealed a small but significant main effect of ε4 on Rey-Osterrieth complex figure delayed recall. Comparing ε2 carriers, ε3 homozygotes, and ε4 carriers, ε3/ε3 performed significantly better on Trail Making Test part B and derived score Trail Making Test B-A. The findings support the relation between the APOE ε polymorphism and visual memory, short-term auditory memory, visuospatial attention, and executive functions in an aging sample without dementia.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Yasser Abdelrazik Mohamed ◽  
Hanan Hany Elrassas ◽  
Zeinab Mohamed Ahmed ◽  
Aya Taha Mohamed

Abstract Background Studies have suggested that Patients with polysubstance abuse (n = 76) and tramadol alone abuse (n = 24) were more likely to have cognitive impairment (CI) (81% and 66.7%, respectively) than the control subjects (28%) as reflected by the total Montreal cognitive assessment (MoCA) scores. All cognitive domains were significantly impaired among tramadol-abuse patients, whereas tramadol-alone patients had significant impairment in all cognitive domains except attention, visuoconstructional (cube), and trail-making test. The most affected cognitive domains were memory, visuospatial skills, and verbal fluency. Reliable estimates of tramadol and synthetic cannabinoids addiction prevalence are important to prevent, treat, and identify causes of addiction, especially in light of recent work revealing a high prevalence of cognitive impairment among drug abusers. Aim of the Work to assess the cognitive function among tramadol & synthetic cannabinoid use disorder patients in addiction clinic of Ain shams university hospitals, as well as comparing the cognitive function between them and healthy adults. Patients and Methods This is a Cross sectional case-control observational study conducted in Ain Shams University hospitals. This present study aimed at analyzing the data of 30 tramadol dependent, 30 synthetic cannabinoid dependent patients & 30 healthy controls, diagnosed by DSM-4 and then they will undergo SCIDI (to exclude any psychiatric comorbidity), SCIDII (for personality disorders), addiction severity index, Wechsler memory scale (for different memory functions), trail making test (for visual attention and task switching) and Benton visual retention test (for visual perception and visual memory), over a period from October 2018 to August 2019. Results A total of 30 tramadol dependent patients, 14 (46.67) were diagnosed as major depressive disorder, 14 (46.67%) as antisocial personality disorder, 23 (76.67) as borderline personality disorder. 26 (86.67 %) patients showed impairment in Benton visual test, 10 (33.33%) patients showed impairment in trail making test. 29 (96.69%) out of 30 patients showed impairment in verbal paired association I & II and visual memory span scales, 30 (100%) out of 30 patients showed impairment in visual paired association I&II and digit span scales. A total 30 synthetic cannabinoid patients, 9 (30%) were diagnosed as psychotic disorder, 7 (23.33%) as bipolar disorder, 1 (3.33%) as major depressive disorder, 19 (63.33%) as antisocial personality disorder, 27 (90%) as borderline personality disorder. 29 (96.67%) patients showed impairment in Benton visual test, 22 (73.33%) patients showed impairment in trail making test. 30 (100%) out of 30 patients showed impairment in visual paired association I&II, verbal paired association I&II, visual memory span and digit span. Conclusion This study provides observation of impaired cognitive function in chronic tramadol and SC users. Tramadol and SC users have shown impairments in visual, auditory, working, immediate, delayed memory and task shifting, as well as an elevation of comorbid psychiatric and personality disorders as psychotic, bipolar and depressive disorders. Also, there was comorbid antisocial and borderline personality disorders. Further research is required to examine the effects of acute and chronic SC consumption on cognitive function with comprehensive explorations of demographic background and objective measurements of substance use.


Author(s):  
Nathalie Sanchia ◽  
Magdalena Surjaningsih Halim

 COGNITIVE STIMULATION THERAPY FOR ELDERLY WITH MILD COGNITIVE IMPAIRMENT: AN EXPERIMENTAL STUDY IN NURSING HOMEABSTRACTIntroduction: Mild cognitive impairment (MCI) is a transitional stage between the elderly’s normal (expected) cognitive decline and the more serious decline caused by dementia that needs interventions. One of the non-pharmacological interventions that can be done is cognitive stimulation therapy (CST). Research has shown that CST can stabilize and/ improve cognitive function in the elderly with MCI.Aims: To find out the differences in cognitive functions in the elderly with MCI and given CST intervention and elderly with MCI not given CST intervention.Methods: This was an experimental study that included elderly aged 60 years old divided into experimental and control group, each consists of four subjects. The experimental group was given CST twice a week with a total of fifteen meetings, but not on the control group. All subjects were subjected to cognitive examinations using neuropsychological instruments before, after, and one month after CST was completed. The statistical analysis performed in this study was Mann-Whitney U Test.Results: There was a significant difference in cognitive function in the attention domain with the trail making test sub-test and the memory domain with the digit pan sub-test after the CST is finished. One month after CST is completed, there were significant differences in cognitive function, in the memory domain.Discussion: The elderly group with MCI given CST has a different cognitive function than elderly group who are not given CST.Keywords: Cognitive function, elderly, mild cognitive impairment, nursing houseABSTRAKPendahuluan: Gangguan kognitif ringan atau mild cognitive impairment (MCI) merupakan proses transisi antara penurunan kognitif normal dan demensia yang perlu diintervensi. Salah satu intervensi non-farmakologis yang dapat dilakukan adalah cognitive stimulation therapy (CST). Banyak penelitian menunjukkan bahwa CST dapat menstabilkan dan/meningkatkan fungsi kognitif pada lansia dengan MCI.Tujuan: Untuk mengetahui pengaruh intervensi CST terhadap fungsi kognitif lansia dengan MCI.Metode: Studi eksperimental pada subjek lansia usia 60 tahun yang dibagi menjadi kelompok eksperimen dan kontrol yang masing-masing terdiri dari 4 subjek. Kelompok eksperimen dilakukan CST dua kali seminggu sebanyak lima belas kali pertemuan, tidak pada kelompok kontrol. Seluruh subjek dilakukan pemeriksaan kognitif dengan menggunakan instrumen neuropsikologi sebelum, sesudah, dan satu bulan setelah CST selesai. Analisis statistik menggunakan Mann- Whitney U test.Hasil: Terdapat perbedaan fungsi kognitif yang signifikan pada domain atensi dengan subtes Trail Making Test dan domain memori dengan subtes digit span setelah CST selesai. Satu bulan setelah CST selesai, terdapat perbedaan fungsi kognitif yang signifikan pada domain memori.Diskusi: Kelompok lansia dengan MCI yang diberikan CST memiliki fungsi kognitif yang berbeda dengan kelompok lansia yang tidak diberikan CST.Kata kunci: Fungsi kognitif, gangguan kognitif ringan, lansia, panti wreda  


2016 ◽  
Vol 49 (6) ◽  
pp. 533
Author(s):  
Nísea De A. Corrêa ◽  
Maria P. Foss ◽  
Paula R. B. Diniz

Objetivo: Verificar as alterações estruturais e funcionais, evidenciadas através da imagem por ressonância magnética, relacionadas aos déficits de memória identificados em idosos normais, quando comparados a adultos jovens. Metodologia: Procedeu-se à revisão sistemática, cujo protocolo obedeceu ao fluxograma do Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram investigadas as bases de dados PubMed, Scopus, EBSCO, utilizando o gerenciador de referências JabRef, na versão 2.10, e o Web of Science, pelo website. Foram incluídos artigos de estudos quase experimentais, transversais, em coorte ou tipo caso-controle, publicados entre 2005 e 2014, em periódicos indexados nacionais e internacionais, cuja amostra incluísse idosos a partir de 60 anos, não dementes, submetidos à investigação de alterações estruturais e funcionais do sistema nervoso central, por ressonância magnética e sua associação com déficits de memória avaliados por testes neuropsicológicos. Resultados: Quanto à técnica de imagem empregada, identificaram-se dois estudos com imagem por ressonância magnética estrutural, seis estudos com utilização de imagem por ressonância magnética funcional, e quatro estudos que empregaram ambas as técnicas. Nos 12 estudos foi identificado o emprego de 38 testes neuropsicológicos distintos, com uma média de cinco testes por estudo, com variação de um a 12 testes. Dentre os testes mais usados, estiveram o WAIS Digit Span Backwards (em sete estudos), o Trail Making Test A and B (em quatro estudos) e o Wechsler Memory Scale (em quatro estudos). Conclusão: Os estudos demonstraram que no envelhecimento normal, ocorre redução do volume de substância branca para-hipocampal, do volume do hipocampo e do córtex entorrinal com redução de memória verbal, possivelmente por desmielinização das fibras; redução das vias que ligam o lobo temporal e frontal, contribuindo para a redução da memória episódica, da memória de trabalho e da fluência verbal; redução da supressão de informações irrelevantes, o que contribui para menor registro de informação; alterações das áreas frontal e parietal que comprometem a memória de reconhecimento; modificações na atividade e na conectividade do default mode network; reorganização das funções cognitivas, bem como alentecimento de resposta por provável redução de ativação do córtex pré- frontal


Dementia ◽  
2016 ◽  
Vol 16 (8) ◽  
pp. 985-1003 ◽  
Author(s):  
Jan Bailey ◽  
Paul Kingston ◽  
Simon Alford ◽  
Louise Taylor ◽  
Edward Tolhurst

This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.


2008 ◽  
Vol 42 (1) ◽  
pp. 143-151 ◽  
Author(s):  
Geana Paula Kurita ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
José Oswaldo de Oliveira Júnior ◽  
Ricardo Caponeiro

Os danos à vida diária que a alteração cognitiva pode provocar motivaram a elaboração deste estudo, cujo objetivo foi analisar o impacto do tratamento da dor com opióides sobre a atenção. Os doentes foram divididos em grupos que recebiam (n=14) e não recebiam opióides (n=12). Foram feitas três entrevistas, utilizando-se o Trail Making Test e o Digit Span Test, que avaliam a atenção. Os grupos foram homogêneos nas variáveis sociodemográficas, dor e depressão; não foram homogêneos no índice de Karnofsky e no recebimento de analgésicos adjuvantes. Os doentes sem opióides tiveram melhor desempenho no Digit Span Test - ordem inversa, na segunda avaliação (p=0,29) e não foram observadas diferenças no Trail Making Test. As alterações observadas foram limitadas, mas, enquanto novos estudos não confirmem os achados, doentes, profissionais e cuidadores devem ser alertados dos possíveis efeitos deletérios dos opióides sobre a função cognitiva.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
U. E. Williams ◽  
M. O. Owolabi ◽  
A. Ogunniyi ◽  
E. O. Ezunu

Background. Cognitive impairment with its negative effect on quality of life has been reported in chronic kidney disease (CKD). The paucity of the literature on cognitive impairment in Africans with CKD prompted this study. Objectives. To determine the frequency and pattern of cognitive impairment in patients with stages 3 to 5 CKD. Methods. We studied 79 consecutive consenting adults with a National Kidney Foundation (NKF) stage 3 to 5 CKD based on their estimated glomerular filtration rate using the Cockcroft-Gault formula. The controls consisted of healthy demographically matched subjects. Community screening instrument for dementia (CSI’D), trail making test A (TMTA), and trail making test B (TMTB) were used for cognitive assessment. Results. More CKD patients had cognitive impairment compared with controls using CSI’D (51.9% versus 2.5%, P<0.001); TMTA (53.2% versus 0%, P<0.001); and TMTB (40% versus 0%, P<0.001). The odds of having cognitive impairment increased in the presence of CKD when assessed using CSI’D (OR = 2.026; CI = 1.607–2.555); TMTA (OR = 3.13; CI = 2.40–4.09) and TMTB (OR = 3.22; CI = 2.42–4.25). CKD patients performed poorer on tests of executive function TMTA (P<0.001) and TMTB (P<0.001) while CSI’D showed significantly lower scores on multiple cognitive domains. Conclusions. Significant cognitive impairment in multiple domains exists among Nigerians with CKD.


Author(s):  
Sari Merilampi ◽  
Antti Koivisto ◽  
Andrew Sirkka

This chapter presents viewpoints of 104 users upon trials on four mobile games which combine cognitive stimulation and physical exercise in rehabilitation. The first game requires users to control by tilting a mobile phone embedded in a balance board; the second game can be controlled by tilting the tablet computer; the third game is a modified version of Trail Making Test A—a memory test that can be played by tapping figures on the screen of tablet computer; and the fourth game is an activation game with a special controller, dedicated for people with severe physical limitations. Users welcomed the use of games as self-rehabilitation tools that can be adjusted according to personal skills and limitations. The games not only gave them meaningful activities, but also saved time and efforts of professional care takers who might be unable to socialize frequently with clients.


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