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.

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.

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.

Describing and measuring the ‘switch-on’ effect in people with dementia who participate in cognitive stimulation therapy: A mixed methods study

2020 ◽  
Vol 83 (5) ◽  
pp. 316-325
Author(s):  
Qi Liu ◽  
Margaret Jones ◽  
Clare Hocking
Keyword(s):  
Mixed Methods ◽  
Group Intervention ◽  
Community Dwelling ◽  
Cognitive Stimulation ◽  
Single Subject ◽  
Mixed Methods Design ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Qualitative Descriptive

Introduction Cognitive stimulation therapy is an evidence-based group intervention for promoting cognition and quality of life in people with dementia. This New Zealand study aimed to describe and measure the ‘switch-on’ effect, a recently reported benefit involving enhanced participation. Method A convergent parallel mixed methods design was implemented. Interviews guided by qualitative descriptive methodology were conducted with four community-dwelling men with mild dementia and their wives, before, during and after cognitive stimulation therapy. Concomitantly, participants with dementia were scored on the Volitional Questionnaire following a single-subject A–B design. Qualitative and quantitative data were analysed using NVivo-assisted thematic analysis and descriptive statistics respectively and conjointly. Findings ‘Switch-on’ was found to be multi-dimensional in nature, with increased engagement and expanded scope in Doing, Feeling, Relating, and Thinking and Reflecting. ‘Switch-on’ occurred with a noticeable onset within 3 weeks, which was sustained and consolidated towards completion of cognitive stimulation therapy in both group and home environments. Three men showed concurrent improvements on the achievement sub-scale of the Volitional Questionnaire. However, the measure did not effectively capture ‘switch-on’ due to its ceiling effect. Conclusion Findings about ‘switch-on’ suggest broader, under-researched benefits of cognitive stimulation therapy that merit further exploration from an occupational therapy perspective.

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.

Mental wellbeing in people with dementia following Cognitive Stimulation Therapy: Innovative practice

Dementia ◽  
2017 ◽  
Vol 19 (2) ◽  
pp. 496-504 ◽  
Author(s):  
Catherine Allward ◽  
Rosie Dunn ◽  
Gemma Forshaw ◽  
Chris Rewston ◽  
Nicola Wass
Keyword(s):  
Well Being ◽  
Service Evaluation ◽  
Cognitive Stimulation ◽  
Mental Wellbeing ◽  
Future Research ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Significant Difference ◽  
Mental Well Being ◽  
General Wellbeing

The benefits of Cognitive Stimulation Therapy in supporting cognitive functioning for people with dementia are well recognised. It has been proposed that Cognitive Stimulation Therapy may offer additional benefits in terms of a person’s sense of general wellbeing. A service evaluation of 60 participants attending Cognitive Stimulation Therapy groups was conducted using the Short Warwick-Edinburgh Mental Well-Being Scale. Although this evaluation did not demonstrate a significant difference between pre- and post-treatment scores (t = −1.75, df = −59, p = −0.085), there was a trend in participants’ reported optimism about the future and confidence. Recommendations about future research in relation to mental wellbeing in dementia care are discussed.

scholarly journals Nonpharmacological Interventions to Improve Depression, Anxiety, and Quality of Life (QoL) in People With Dementia: An Overview of Systematic Reviews

2019 ◽  
Vol 33 (1) ◽  
pp. 28-41 ◽  
Author(s):  
Naoko Kishita ◽  
Tamara Backhouse ◽  
Eneida Mioshi
Keyword(s):  
Quality Of Life ◽  
Systematic Reviews ◽  
Cognitive Stimulation ◽  
Current Evidence ◽  
Future Research ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
People With Dementia ◽  
Current Evidence Base

This overview aimed to systematically synthesize evidence from existing systematic reviews to signpost practitioners to the current evidence base on nonpharmacological interventions to improve depression, anxiety, and quality of life (QoL) in people with dementia and to discuss priorities for future research. The databases MEDLINE, PsycINFO, Scopus, and Cochrane Central Register of Controlled Trials were searched in August 2017 with an updated search in January 2019. Fourteen systematic reviews of randomized controlled trials of nonpharmacological interventions were identified. Dementia stage was rated moderate or severe in the majority of the reviews and type of dementia varied. Interventions reported to be effective were cognitive stimulation (QoL: standardized mean difference [SMD] = 0.38), music-based therapeutic interventions (depression: SMD = −0.27, anxiety: SMD = −0.43, QoL: SMD = 0.32), and psychological treatments (mainly cognitive behavior therapy; depression: SMD = −0.22, anxiety: MD = −4.57). Although health-care professionals are recommended to continue using these approaches, future research needs to focus on the type and form of interventions that are most effective for different stages and types of dementia.

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