Efficacy of a cognitive stimulation therapy programme for people with dementia

Coen, Robert F.; Flynn, B O; Rigney, Edel; O’Connor, Elaine; Fitzgerald, Liza; Murray, Ciaran; Dunleavy, Catherine; McDonald, Mindy; Delaney, Deirdre; Merriman, Niamh A.; Edgeworth, Jennifer

doi:10.1017/s0790966700012131

Cited by 51 publications

(50 citation statements)

References 17 publications

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“…47 Two reviewers independently assessed eligibility. Of the 94 references, nine studies met the inclusion criteria [48][49][50][51][52][53][54][55] and were included in the analysis. Three recent studies were left awaiting classification.…”

Section: Studies Included In the Reviewmentioning

confidence: 99%

“…49,51,53 All of the studies reported on attrition to the programme, although the intention-to-treat analysis plan was described in only two. 6,51 Given the nature of the condition and the age of the participants, attrition in several studies was remarkably small, with zero attrition recorded in six studies [48][49][50]52,59,60 out of 180 participants. The largest attrition rate was reported in the study by Wallis et al, 63 in which there was 39% attrition in the group of participants with dementia.…”

Section: Figurementioning

confidence: 99%

“…Data were identified, included and pooled from the 15 included RCTs, 6,[48][49][50][51][52][53][54][55][59][60][61][62][63][64] with a total of 718 participants (407 in experimental groups and 311 in control groups). Analyses were adjusted to the random-effects model, owing to the heterogeneity of trials, and SMDs, because trials used different measures to assess the same outcomes.…”

Section: Meta-analysismentioning

confidence: 99%

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Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Orrell

Hoe

Charlesworth

et al. 2017

Programme Grants Appl Res

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BackgroundDementia is a national priority and this research addresses the Prime Minister’s commitment to dementia research as demonstrated by his 2020 challenge and the new UK Dementia Research Institute. In the UK > 800,000 older people have dementia. It has a major impact on the lives of people with dementia themselves, on the lives of their family carers and on services, and costs the nation £26B per year. Pharmacological cures for dementias such as Alzheimer’s disease are not expected before 2025. If no cure can be found, the ageing demographic will result in 2 million people living with dementia by 2050. People with dementia lose much more than just their memory and their daily living skills; they can also lose their independence, their dignity and status, their confidence and morale, and their roles both within the family and beyond. They can be seen as a burden by society, by their families and even by themselves, and may feel unable to contribute to society. This programme of research aims to find useful interventions to improve the quality of life of people with dementia and their carers, and to better understand how people with dementia can be supported at home and avoid being admitted to hospital.Objectives(1) To develop and evaluate the maintenance cognitive stimulation therapy (MCST) for people with dementia; (2) to develop the Carer Supporter Programme (CSP), and to evaluate the CSP and Remembering Yesterday, Caring Today (RYCT) for people with dementia both separately and together in comparison with usual care; and (3) to develop a home treatment package (HTP) for dementia, to field test the HTP in practice and to conduct an exploratory trial.Methods(1) The MCST programme was developed for people with dementia based on evidence and qualitative work. A randomised controlled trial (RCT) [with a pilot study of MCST plus acetylcholinesterase inhibitors (AChEIs)] compared MCST with cognitive stimulation therapy (CST) only. The MCST implementation study conducted a trial of outreach compared with usual care, and assessed implementation in practice. (2) The CSP was developed based on existing evidence and the engagement of carers of people with dementia. The RCT (with internal pilot) compared the CSP and reminiscence (RYCT), both separately and in combination, with usual care. (3) A HTP for dementia, including the most promising interventions and components, was developed by systematically reviewing the literature and qualitative studies including consensus approaches. The HTP for dementia was evaluated in practice by conducting in-depth field testing.Results(1) Continuing MCST improved quality of life and improved cognition for those taking AChEIs. It was also cost-effective. The CST implementation studies indicated that many staff will run CST groups following a 1-day training course, but that outreach support helps staff go on to run maintenance groups and may also improve staff sense of competence in dementia care. The study of CST in practice found no change in cognition or quality of life at 8-month follow-up. (2) The CSP/RYCT study found no benefits for family carers but improved quality of life for people with dementia. RYCT appeared beneficial for the quality of life of people with dementia but at an excessively high cost. (3) Case management for people with dementia reduces admissions to long-term care and reduces behavioural problems. In terms of managing crises, staff suggested more costly interventions, carers liked education and support, and people with dementia wanted family support, home adaptations and technology. The easy-to-use home treatment manual was feasible in practice to help staff working in crisis teams to prevent hospital admissions for people with dementia.LimitationsGiven constraints on time and funding, we were unable to compete the exploratory trial of the HTP package or to conduct an economic evaluation.Future researchTo improve the care of people with dementia experiencing crises, a large-scale clinical trial of the home treatment manual is needed.ConclusionThere is an urgent need for effective psychosocial interventions for dementia. MCST improved quality of life and was cost-effective, with benefits to cognition for those on AChEIs. MCST was feasible in practice. Both CSP and RYCT improved the quality of life of people with dementia, but the overall costs may be too high. The HTP was useful in practice but requires evaluation in a full trial. Dementia care research may improve the lives of millions of people across the world.Trial registrationsCurrent Controlled Trials ISRCTN26286067 (MCST), ISRCTN28793457 (MCST implementation) and ISRCTN37956201 (CSP/RYCT).FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 5. See the NIHR Journals Library website for further project information.

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Section: Studies Included In the Reviewmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Section: Meta-analysismentioning

confidence: 99%

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Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Orrell

Hoe

Charlesworth

et al. 2017

Programme Grants Appl Res

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“…Of the seven studies that did provide this information (15)(16)(17)(18)(19)(20)(21), group sizes ranged from 3 (18) to 15 (19).…”

Section: Groupsmentioning

confidence: 99%

Descriptions of memory rehabilitation group interventions for neurological conditions: a systematic review

2015

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A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Review methods: Articles were included if the sample were adults with a neurological disorder, the intervention was group-based cognitive rehabilitation for memory problems, and if the study was a randomised controlled trial. Articles were independently screened for inclusion and data extracted by two researchers, with the third researcher arbitrating any disputes.Results: Fourteen studies were included in this review. The reporting of certain aspects of an intervention was found to be poor, particularly in relation to: duration of the programme (6 of 14 studies did not report), the development of the intervention (7 of 14 studies did not discuss), and the content and structure of intervention (7 of the 14 studies did not provide details Review methods: Articles were included if the sample were adults with a neurological disorder, the intervention was group-based cognitive rehabilitation for memory problems, and if the study was a randomised controlled trial. Articles were independently screened for inclusion and data extracted by two researchers, with the third researcher arbitrating any disputes.Results: Fourteen studies were included in this review. The reporting of certain aspects of an intervention was found to be poor, particularly in relation to: duration of the programme (6 of 14 studies did not report), the development of the intervention (7 of 14 studies did not discuss), and the content and structure of intervention (7 of the 14 studies did not provide details).Conclusion: This review found that the overall reporting of memory rehabilitation content and format is poor.Refinement and adaption of pre-existing checklists to capture aspects of cognitive rehabilitation programmes may help authors when reporting complex interventions. A draft checklist is provided that could be refined and validated in further research.

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“…Hace más de una década que, la investigación sobre la mejora de las funciones cognitivas en personas mayores, ha concentrado esfuerzos hacia la intervención, tanto en población mayor general (Martin, Clare, Altgassen, Cameron y Zehnder, 2011;Tardif y Simard, 2011), como en personas con deterioro cognitivo (Reijnders, van Heugten y van Boxtel, 2013;Teixeira et al, 2012) o demencia (Coen et al, 2011;Woods, Aguirre, Spector y Orrell, 2012).…”

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Estimulación de la Inteligencia Emocional en mayores: El programa PECI-PM

Pérez-Fuentes¹,

Molero²,

Gázquez³

et al. 2015

Ejihpe

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El programa de Estimulación Cognitiva e Inteligencia Emocional para personas mayores (PECI-PM), combina técnicas de estimulación cognitiva con la intervención y estimulación sobre aspectos relacionados con la inteligencia emocional. El objetivo del presente trabajo es analizar los resultados obtenidos en inteligencia emocional, tras la primera fase de implementación del PECI-PM. Para ello, se contó con una muestra de 28 usuarios del programa, que habían completado 20 sesiones y participado en las dos evaluaciones (pre-post). La Inteligencia Emocional se evaluó, antes y después de la intervención, mediante el Inventario Breve de Inteligencia Emocional para Mayores (EQ-i-M20). Tras la intervención con el PECI-PM, se observa una mejora, en la mayoría de las dimensiones de inteligencia emocional (Intrapersonal, Interpersonal, Adaptabilidad y Estado de Ánimo). En la dimensión Manejo del Estrés, no se observa un cambio en las puntuaciones obtenidas tras la intervención, lo que lleva a replantear el peso de esta dimensión en la inteligencia emocional de la población mayor. Por otro lado, destaca el papel de la dimensión Interpersonal, que correlaciona significativamente con otros factores de la inteligencia emocional (Intrapersonal y Adaptabilidad), en mayores. After intervention with the PECI-PM, improvement was observed in most of the emotional intelligence dimensions (Intrapersonal, Interpersonal, Adaptability and Mood). In the Stress Management dimension, there was no change in scores after intervention, which leads us to reconsider the weight of this emotional intelligence dimension in the older population. On the other hand, the role of the Interpersonal dimension, which correlates significantly with other emotional intelligence factors (Intrapersonal and Adaptability) in older people, should be emphasized.

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Efficacy of a cognitive stimulation therapy programme for people with dementia

Abstract: Even though the sample sizes are small the current study is consistent with the Spector et al's findings in 2003 of beneficial effects in people with dementia following CST. The programme is recommended as an intervention for people with mild to moderate dementia.

Cited by 51 publications

References 17 publications

Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Support at Home: Interventions to Enhance Life in Dementia (SHIELD) – evidence, development and evaluation of complex interventions

Descriptions of memory rehabilitation group interventions for neurological conditions: a systematic review

Estimulación de la Inteligencia Emocional en mayores: El programa PECI-PM

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