The Efficacy of Cognitive Stimulation Therapy (CST) for People With Mild-to-Moderate Dementia

2019 ◽  
Vol 24 (3) ◽  
pp. 257-277 ◽  
Author(s):  
Alessandra Lobbia ◽  
Elena Carbone ◽  
Silvia Faggian ◽  
Simona Gardini ◽  
Federica Piras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Cognitive Functioning ◽  
Cognitive Stimulation ◽  
Present Review ◽  
Levels Of Evidence ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Moderate Dementia

Abstract. Cognitive Stimulation Therapy (CST) is an internationally used, evidence-based psychosocial intervention for people with mild-to-moderate dementia. The present review thus aimed specifically to examine the reliability of the findings and the strength of the evidence obtained in studies on the CST protocol concerning any benefit in terms of cognitive functioning, perceived quality of life, psychological, behavioral, and everyday life functioning of people with dementia, and their family caregivers’ health status, quality of life, and burden of care. A systematic literature search on studies specifically adopting the CST protocol in patients with mild-to-moderate DSM-IV dementia – eventually involving their family members – was performed. A total of 238 papers were screened and 12 finally included in the qualitative analysis after inclusion/exclusion criteria were applied. The Jadad Scale and the Stroke Prevention and Educational Awareness Diffusion (SPREAD) method were used to appraise the studies’ methodological quality. Moderate levels of evidence emerged for general cognitive functioning, language comprehension and production, and quality of life. The levels of evidence were weaker for short-term memory, orientation, praxis, depression, social and emotional loneliness, behavior, and communication in people with dementia, and for their caregivers’ health status and anxiety symptoms. Albeit with the limited quality of reviewed evidence, and the need for more studies on CST, the present review highlights the value of this program as part of dementia care services to sustain the cognitive functioning and quality of life of people with dementia.

A multicomponent psychosocial intervention among people with early-stage dementia involving physical exercise, cognitive stimulation therapy, psychoeducation and counselling: Results from a mixed-methods study

Dementia ◽  
2021 ◽  
pp. 147130122110406
Author(s):  
Sofie S Skov ◽  
Maj Britt D Nielsen ◽  
Rikke F Krølner ◽  
Laila Øksnebjerg ◽  
Sigurd M Rønbøl Lauridsen
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Cognitive Functioning ◽  
Early Stage ◽  
Psychosocial Interventions ◽  
Cognitive Stimulation ◽  
Cognitive Stimulation Therapy ◽  
Multicomponent Intervention ◽  
People With Dementia

Background There is increasing awareness of the benefits of both physical and psychosocial interventions to empower and benefit people with dementia and their caregivers. However, the potential additional benefits of combining physical and psychosocial interventions have only been sparsely explored. The aim of this pilot study was to investigate the acceptability and potential impact of a multicomponent intervention comprising physical exercise, cognitive stimulation therapy (CST), psychoeducation and counselling for people with early-stage dementia. Design A 15-week multicomponent group-based intervention was offered to people with early-stage dementia in Denmark ( N = 44). A mixed-methods design combining interviews, observations, tests of cognitive and physical functioning and an interviewer-assisted questionnaire on quality of life was applied to (1) investigate acceptability of the intervention, including whether people with dementia and their caregivers found the intervention meaningful and (2) to explore and assess changes in participants’ physical and cognitive functioning and quality of life. The study was conducted between June 2018 and August 2019. Results The pilot study demonstrated that the multicomponent intervention was acceptable for people with early-stage dementia and their caregivers. Test results did not show significant changes in measures of participants’ physical and cognitive functioning or quality of life. However, qualitative data revealed that participants perceived the intervention as meaningful and found that it had a positive influence on their physical and social well-being. In addition, interaction and support from peers and staff members was considered important and rewarding. Conclusion This multicomponent intervention constitutes a meaningful and beneficial activity for people with early-stage dementia and their caregivers. It provides an opportunity to engage in social interactions with peers and experience professional support. The study also underlines the importance of providing prolonged and sustainable interventions for people with dementia to maintain personal and social benefits.

scholarly journals Cognitive stimulation therapy (CST) for people with dementia in practice: An observational study

2016 ◽  
Vol 79 (12) ◽  
pp. 762-767 ◽  
Author(s):  
Amy Streater ◽  
Aimee Spector ◽  
Elisa Aguirre ◽  
Martin Orrell
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Routine Care ◽  
Cognitive Stimulation ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Moderate Dementia

Introduction The delivery of cognitive stimulation as a cognitive based psychosocial intervention for people with mild to moderate dementia is supported in the National Institute for Health and Care Excellence guidelines. There is a strong evidence base for its effectiveness in providing improvements in cognition and quality of life for people with dementia. However, less is known about its delivery and its impact using outcome measures when used in practice. Methods A 1-year observational study was conducted, which measured the cognition and quality of life of 89 people with dementia living in care homes and the community and were in receipt of cognitive stimulation therapy and a maintenance programme as part of their usual care in practice. Results A paired sample T-test demonstrated a significant improvement in cognition. Quality of life remained unchanged for people with mild to moderate dementia. Conclusions This study reports promising findings with demonstrated benefits for people with dementia and strengthens the evidence base supporting its use in routine care. However, attention should be given to the level of cognitive impairment of attendees. This research is relevant to the field of occupational therapy as the profession has knowledge of using psychosocial interventions and a commitment to evidence-based practice.

scholarly journals An evaluation of community-based cognitive stimulation therapy: a pilot study with an Irish population of people with dementia

2016 ◽  
Vol 34 (3) ◽  
pp. 157-167 ◽  
Author(s):  
M. E. Kelly ◽  
S. Finan ◽  
M. Lawless ◽  
N. Scully ◽  
J. Fitzpatrick ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Well Being ◽  
Cognitive Stimulation ◽  
Post Intervention ◽  
Community Based ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Subjective Cognitive Function

ObjectivesResearch shows that cognitive stimulation therapy (CST) improves cognitive function, quality of life, and well-being of people with mild–moderate dementia. Despite consistent evidence and recommendations, CST is not routinely available in Ireland post-diagnosis. The aim of the current research was to develop and evaluate community-based CST for people with mild–moderate dementia, run by the Alzheimer Society of Ireland across four pilot sites in Ireland.MethodsParticipants with mild–moderate dementia attended once weekly CST sessions for 14 weeks. Baseline and post-intervention assessments were completed by CST participants, carers, and CST facilitators. Primary outcomes of interest for CST participants included quality of life (Quality of Life in Alzheimer Disease Scale), cognitive function (Montreal Cognitive Assessment), and subjective cognitive function (Memory Awareness Rating Scale-Functioning Subscale). Secondary outcomes included well-being, cognitive ability, satisfaction with cognitive performance, and engagement and confidence of CST participants; well-being of carers; and job satisfaction of facilitators. Post-intervention interviews supplemented quantitative analyses.ResultsIn total, 20 CST participants, 17 carers, and six CST facilitators completed evaluation assessments. Results showed that CST improved participants’ satisfaction with cognitive performance (p=0.002), level of engagement (p=0.046), level of confidence (p=0.026). Improvements on subjective cognitive function just fell short of significance (p=0.055). Qualitative analysis of interview data identified consistent themes of cognitive and overall benefits of CST; and provided support for quantitative data.ConclusionsCommunity-based CST positively impacted the lives of people with dementia and their families. This study supports prior recommendations that CST should be made routinely available to people with mild–moderate dementia, particularly in light of the lack of post-diagnostic interventions currently offered in Ireland.

scholarly journals Mixed methods implementation research of cognitive stimulation therapy (CST) for dementia in low and middle-income countries: study protocol for Brazil, India and Tanzania (CST-International)

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030933 ◽  
Author(s):  
Aimee Spector ◽  
Charlotte R Stoner ◽  
Mina Chandra ◽  
Sridhar Vaitheswaran ◽  
Bharath Du ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Cognitive Stimulation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Implementation Plans

IntroductionIn low/middle-income countries (LMICs), the prevalence of people diagnosed with dementia is expected to increase substantially and treatment options are limited, with acetylcholinesterase inhibitors not used as frequently as in high-income countries (HICs). Cognitive stimulation therapy (CST) is a group-based, brief, non-pharmacological intervention for people with dementia that significantly improves cognition and quality of life in clinical trials and is cost-effective in HIC. However, its implementation in other countries is less researched. This protocol describes CST-International; an implementation research study of CST. The aim of this research is to develop, test, refine and disseminate implementation strategies for CST for people with mild to moderate dementia in three LMICs: Brazil (upper middle-income), India (lower middle-income) and Tanzania (low-income).Methods and analysisFour overlapping phases: (1) exploration of barriers to implementation in each country using meetings with stakeholders, including clinicians, policymakers, people with dementia and their families; (2) development of implementation plans for each country; (3) evaluation of implementation plans using a study of CST in each country (n=50, total n=150). Outcomes will include adherence, attendance, acceptability and attrition, agreed parameters of success, outcomes (cognition, quality of life, activities of daily living) and cost/affordability; (4) refinement and dissemination of implementation strategies, enabling ongoing pathways to practice which address barriers and facilitators to implementation.Ethics and disseminationEthical approval has been granted for each country. There are no documented adverse effects associated with CST and data held will be in accordance with relevant legislation. Train the trainer models will be developed to increase CST provision in each country and policymakers/governmental bodies will be continually engaged with to aid successful implementation. Findings will be disseminated at conferences, in peer-reviewed articles and newsletters, in collaboration with Alzheimer’s Disease International, and via ongoing engagement with key policymakers.

scholarly journals Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia

2003 ◽  
Vol 183 (3) ◽  
pp. 248-254 ◽  
Author(s):  
Aimee Spector ◽  
Lene Thorgrimsen ◽  
Bob Woods ◽  
Lindsay Royan ◽  
Steve Davies ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Older People ◽  
Intervention Group ◽  
Cognitive Stimulation ◽  
Control Group ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia

BackgroundA recent Cochrane review of reality orientation therapy identified the need for large, well-designed, multi-centre trials.AimsTo test the hypothesis that cognitive stimulation therapy (CST) for older people with dementia would benefit cognition and quality of life.MethodA single-blind, multi-centre, randomised controlled trial recruited 201 older people with dementia. The main outcome measures were change in cognitive function and quality of life. An intention-to-treat analysis used analysis of covariance to control for potential variability in baseline measures.ResultsOne hundred and fifteen people were randomised within centres to the intervention group and 86 to the control group. At follow-up the intervention group had significantly improved relative to the control group on the Mini-Mental State Examination (P=0.044), the Alzheimer's Disease Assessment Scale – Cognition (ADAS–Cog) (P=0.014) and Quality of Life – Alzheimer's Disease scales (P=0.028). Using criteria of 4 points or more improvement on the ADAS–Cog the number needed to treat was 6 for the intervention group.ConclusionThe results compare favourably with trials of drugs for dementia. CST groups may have worthwhile benefits for many people with dementia.

scholarly journals The Acceptability and Usefulness of Cognitive Stimulation Therapy for Older Adults with Dementia: A Narrative Review

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Hui Moon Toh ◽  
Shazli Ezzat Ghazali ◽  
Ponnusamy Subramaniam
Keyword(s):  
Older Adults ◽  
Cultural Context ◽  
Qualitative Studies ◽  
Cognitive Stimulation ◽  
Future Research ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Evidence Based Therapy

Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers’ wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST’s effectiveness.

scholarly journals Efficacy of cognitive stimulation therapy for older adults with vascular dementia

2017 ◽  
Vol 11 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Federica Piras ◽  
Elena Carbone ◽  
Silvia Faggian ◽  
Elisa Salvalaio ◽  
Simona Gardini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Functioning ◽  
Vascular Dementia ◽  
Cognitive Stimulation ◽  
The Other ◽  
Cognitive Stimulation Therapy

ABSTRACT. Background: Cognitive stimulation therapy (CST) is an evidence-based psychosocial intervention for people with mild-to-moderate dementia due to various etiological factors. Objective: The aim of the present study was to assess the efficacy of the CST program, Italian adaptation -CST-IT-, in individuals who have vascular dementia (VaD). Methods: Older adults with mild-to-moderate VaD (N = 35) were assigned to one of two programs: one group (N = 21) attended the 14 sessions of the CST-IT program, while the other, active control group (N = 14) took part in alternative activities. The following domains were examined: cognitive functioning, quality of life, mood, behavior, functional activities of daily living. Results: Compared with the active controls, the CST-IT group showed a greater improvement in general cognitive functioning after the intervention (i.e. score increase on the Mini-Mental State Examination and decrease on the Alzheimer's Disease Assessment Scale – Cognitive subscale). A trend towards improvement was also identified in short-term/working memory – the backward digit span task- and perceived quality of life (Quality of Life – Alzheimer's Disease scale). No significant differences emerged between the two groups for the other domains considered. Conclusion: The present results support the efficacy of CST in people with vascular dementia.

scholarly journals Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial

2014 ◽  
Vol 204 (6) ◽  
pp. 454-461 ◽  
Author(s):  
Martin Orrell ◽  
Elisa Aguirre ◽  
Aimee Spector ◽  
Zoe Hoare ◽  
Robert T. Woods ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cognitive Stimulation ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Randomised Controlled ◽  
Single Blind ◽  
Pragmatic Randomised Controlled Trial

BackgroundThere is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.AimsTo evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).MethodThe participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).ResultsFor the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).ConclusionsContinuing CST improves quality of life; and improves cognition for those taking AChEIs.

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