Faculty Opinions recommendation of Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial.

Author(s):  
Allan Young ◽  
Jorge Palacios
2014 ◽  
Vol 204 (6) ◽  
pp. 454-461 ◽  
Author(s):  
Martin Orrell ◽  
Elisa Aguirre ◽  
Aimee Spector ◽  
Zoe Hoare ◽  
Robert T. Woods ◽  
...  

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.


BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022136 ◽  
Author(s):  
Afia Ali ◽  
Emma Brown ◽  
Aimee Spector ◽  
Elisa Aguirre ◽  
Angela Hassiotis

IntroductionCognitive stimulation therapy (CST) is a psychosocial intervention for dementia. Group CST is effective in reducing cognitive decline and improving quality of life in patients with dementia. There is some evidence that individual CST (iCST) may be beneficial in reducing cognitive decline. People with intellectual disability (ID) have an increased risk of dementia. However, there are no published studies of CST in people with ID and dementia. This protocol describes the feasibility and acceptability of a randomised controlled trial of iCST delivered by carers to people with ID and dementia, compared with treatment as usual (TAU). The results of this study will inform the design of a future definitive randomised controlled trial.Methods and analysisThe iCST intervention has been adapted for this trial. Forty dyads (individuals with ID and their carer) will be randomised to either iCST or TAU. The manualised intervention comprises 40 iCST sessions delivered by a carer for 30 min, twice a week, over 20 weeks. The primary outcome will be process measures assessing the feasibility and acceptability of the intervention and trial procedures. The secondary outcome will be changes in the scores of outcome measures (cognition, functional ability and quality of life in individuals with ID, and caregiver burden, competence in managing dementia, and anxiety and depression in carers). Data will be collected at baseline, 11 weeks and at 21 weeks. A process evaluation will examine adherence to iCST and will include qualitative interviews with participants to identify aspects of the intervention that were or were not successful.Ethics and disseminationThe study has received ethical approval. The results of the study will be presented at conferences and submitted to a peer reviewed journal.Trial registration numberISRCTN18312288; Pre-results.


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