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.
AguirreESpectorAHoeJ (2010) Maintenance Cognitive Stimulation Therapy (CST) for dementia: A single-blind, multi-centre, randomized controlled trial of maintenance CST vs. CST for dementia. Trials11: 46.
2.
Aguirre E, Spector A and Streater A (2011) Making a Difference 2: An evidence-based group programme to offer maintenance Cognitive Stimulation Therapy (CST) to people with dementia. London: Hawker Publications Ltd.
3.
BennettSBennettJ (2001) The process of an evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal47(4): 171–180.
4.
BlackN (1996) Why we need observational studies to evaluate the effectiveness of health care. British Medical Journal312(7040): 1215–1218.
5.
BoersmaPvan WeertJlakerveldJ (2015) The art of successful implementation of psychosocial interventions in residential dementia care: A systematic review of the literature based on the RE-AIM framework. International Psychogeriatrics27(01): 19–35.
6.
BossersWvan der WoudeLBoersmaF (2012) Recommended measures for the assessment of cognitive and physical performance in older patients with dementia: A systematic review. Dementia and Geriatric Cognitive Disorders EXTRA2(1): 589–609.
CoveJJacobiNDonovanH (2014) Effectiveness of weekly cognitive stimulation therapy for people with dementia and the additional impact of enhancing cognitive stimulation therapy with a carer training program. Clinical interventions in aging11(9): 2143–2150.
9.
Department of Health (2005) (2005) Mental Capacity Act, London, England: HMSO.
10.
FolsteinMFolsteinSMcHughP (1975) ‘Mini Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research12(3): 189–198.
11.
GlumSGoldsteinJLocK (2013) Cognitive performance on the mini-mental state examination and the Montreal cognitive assessment across the healthy adult lifespan. Cognitive and Behavioral Journal26(1): 1–5.
12.
Guss R, Middleton J, Beanland T, et al. (2014) A guide to psychosocial interventions in early stages of dementia. Leicester, UK: The British Psychological Society, November 2014.
13.
HodgeSHaileyE (2013) English National Memory Clinics Audit Report, London, England: Royal College of Psychiatrists.
14.
HughesCBergLDanzigerW (1982) A new clinical scale for the staging of dementia. British Journal of Psychiatry140(6): 566–572.
15.
KorczakDHabermannCBrazS (2013) The effectiveness of occupational therapy for persons with moderate and severe dementia. GMS Health Technology Assessment5(9): 1–7.
16.
LawMCooperBStrongS (1996) The person-environment-occupation model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy63(1): 9–23.
17.
LawrenceVFosseyJBallardC (2012) Improving quality of life for people with dementia in care homes: Making psychosocial interventions work. The British Journal of Psychiatry201(5): 344–351.
18.
LelandNCrumKPhippsS (2015) Advancing the value and quality of occupational therapy in health service delivery. American Journal of Occupational Therapy69(1): 1–7.
19.
LogsdonRGGibbonsLEMcCurrySM (1999) Quality of life in Alzheimer’s disease: Patient and caregiver reports. Journal of Mental Health and Aging5(1): 21–32.
20.
MerchantCHopeK (2004) The quality of life in Alzheimer’s disease scale: Direct assessment of people with cognitive impairment. Journal of Clinical Nursing13(6B): 105–110.
21.
Moniz-CookEVernooij-DassenMWoodsR (2008) A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging & Mental Health12(1): 14–25.
22.
National Institute for Health and Clinical Excellence. (2006) Dementia: supporting people with dementia and their carers in health and social care. NICE clinical guideline 42, November 2006. www.nice.org.uk/guidance/cg42.
23.
OrrellMAguirreESpectorA (2014) Maintenance cognitive stimulation therapy for dementia: Single-blind, multicentre, pragmatic randomised controlled trial. The British Journal of Psychiatry204(6): 454–461.
24.
OrrellMSpectorAThorgrimsenL (2005) A pilot study examining the effectiveness of maintenance cognitive stimulation therapy (MCST) for people with dementia. International Journal of Geriatric Psychiatry20(5): 446–451.
25.
SheehanB (2012) Assessment scales for dementia. Therapeutic Advances in Neurological Disorders5(6): 349–358.
26.
SpectorAGardnerCOrrellM (2011) The impact of cognitive stimulation therapy groups on people with dementia: Views from participants, their carers and group facilitators. Aging and Mental Health15(8): 945–949.
27.
SpectorAThorgrimsenLWoodsB (2003) Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: Randomised controlled trial. The British Journal of Psychiatry183(3): 248–254.
28.
SpectorAThorgrimsenLWoodsB (2006) Making a Difference: An Evidence-based Group Programme to Offer Cognitive Stimulation Therapy (CST) to People with Dementia, London: Hawker Publications Ltd.
29.
Streater A, Aguirre E, Spector A, et al. (2016) Cognitive stimulation therapy for people with dementia in practice: A service evaluation. British Journal of Occupational Therapy 79(9): 574–580.
30.
StreaterASpectorAAguirreE (2012) Maintenance cognitive stimulation therapy (CST) in practice: study protocol for a randomized controlled trial. Trials13(1): 91.
31.
TombaughTNMcIntyreNJ (1992) The mini-mental state examination: A comprehensive review. Journal of the American Geriatrics Society40(9): 922–935.
32.
Vernooij-DassenMMoniz-CookE (2014) Raising the standard of applied dementia care research: addressing the implementation error. Aging & Mental Health18(7): 809–814.
33.
YuillNHollisV (2011) A systematic review of cognitive stimulation therapy for older adults with mild to moderate dementia: An occupational therapy perspective. Occupational Therapy International18(4): 163–186.
