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

Orrell, Martin; Aguirre, Elisa; Spector, Aimee; Hoare, Zoë; Woods, Bob; Streater, Amy; Donovan, Helen; Hoe, Juanita; Knapp, Martín; Whitaker, Christopher J.; Russell, Ian

doi:10.1192/bjp.bp.113.137414

Cited by 139 publications

(122 citation statements)

References 35 publications

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“…Research with other psychosocial interventions indicates sustainability of effects is rare without further maintenance sessions (Orrell et al, 2014). Consequently, regular, and good quality activities should be a core component of care.…”

Section: Discussionmentioning

confidence: 99%

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation

Windle

Joling

Howson-Griffiths

et al. 2017

Int. Psychogeriatr.

124

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Section: Discussionmentioning

confidence: 99%

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation

Windle

Joling

Howson-Griffiths

et al. 2017

Int. Psychogeriatr.

124

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“…Correct 'definite' judgement 22 (19) 4 (3) 26 (10) Correct 'more likely' judgement 17 (15) 17 (12) 34 (13) Equally likely to be in iCST or TAU 65 (57) 80 (57) 145 (57) Incorrect 'more likely' judgement 10 (9) 31 (22) 41 (16) Incorrect 'definite' judgement 0 9 (6) 9 (4) …”

Section: Demographic Informationmentioning

confidence: 99%

“…The first part of the session focused on describing the programme, familiarising carers with the iCST materials and explaining key principles of the intervention. A clip of a DVD developed in the recent maintenance group CST trial 19 was shown in order to demonstrate principles and examples of activities. The second part of the session focused on practising an iCST session with support from the researcher.…”

Section: Training and Supportmentioning

confidence: 99%

“…During initial consultations of manual development, two family carers and two health and social care professionals were consulted. Carers' and professionals' feedback was sought in relation to the adaptation of group CST approaches 6,19 and the key characteristics of previous individual cognitive-based interventions involving carers. 10,12 These consultations concluded that a carer-led manual should adapt similar layouts to those used in previous literature (i.e.…”

Section: Development Study 1: Service Users' Views About the Intervenmentioning

confidence: 99%

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Individual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial

Orgeta

Leung

Yates

et al. 2015

Health Technol Assess

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153

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BackgroundGroup cognitive stimulation therapy programmes can benefit cognition and quality of life for people with dementia. Evidence for home-based, carer-led cognitive stimulation interventions is limited.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of carer-delivered individual cognitive stimulation therapy (iCST) for people with dementia and their family carers, compared with treatment as usual (TAU).DesignA multicentre, single-blind, randomised controlled trial assessing clinical effectiveness and cost-effectiveness. Assessments were at baseline, 13 weeks and 26 weeks (primary end point).SettingParticipants were recruited through Memory Clinics and Community Mental Health Teams for older people.ParticipantsA total of 356 caregiving dyads were recruited and 273 completed the trial.InterventioniCST consisted of structured cognitive stimulation sessions for people with dementia, completed up to three times weekly over 25 weeks. Family carers were supported to deliver the sessions at home.Main outcome measuresPrimary outcomes for the person with dementia were cognition and quality of life. Secondary outcomes included behavioural and psychological symptoms, activities of daily living, depressive symptoms and relationship quality. The primary outcome for the family carers was mental/physical health (Short Form questionnaire-12 items). Health-related quality of life (European Quality of Life-5 Dimensions), mood symptoms, resilience and relationship quality comprised the secondary outcomes. Costs were estimated from health and social care and societal perspectives.ResultsThere were no differences in any of the primary outcomes for people with dementia between intervention and TAU [cognition: mean difference –0.55, 95% confidence interval (CI) –2.00 to 0.90;p-value = 0.45; self-reported quality of life: mean difference –0.02, 95% CI –1.22 to 0.82;p-value = 0.97 at the 6-month follow-up]. iCST did not improve mental/physical health for carers. People with dementia in the iCST group experienced better relationship quality with their carer, but there was no evidence that iCST improved their activities of daily living, depression or behavioural and psychological symptoms. iCST seemed to improve health-related quality of life for carers but did not benefit carers’ resilience or their relationship quality with their relative. Carers conducting more sessions had fewer depressive symptoms. Qualitative data suggested that people with dementia and their carers experienced better communication owing to iCST. Adjusted mean costs were not significantly different between the groups. From the societal perspective, both health gains and cost savings were observed.ConclusionsiCST did not improve cognition or quality of life for people with dementia, or carers’ physical and mental health. Costs of the intervention were offset by some reductions in social care and other services. Although there was some evidence of improvement in terms of the caregiving relationship and carers’ health-related quality of life, iCST does not appear to deliver clinical benefits for cognition and quality of life for people with dementia. Most people received fewer than the recommended number of iCST sessions. Further research is needed to ascertain the clinical effectiveness of carer-led cognitive stimulation interventions for people with dementia.Trial registrationCurrent Controlled Trials ISRCTN65945963.FundingThis project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA) programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 64. See the NIHR Journals Library website for further information.

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“…La estimulación cognitiva se basa en la evidencia empírica que indica que los individuos con demencia conservan cierta capacidad de aprendizaje (Orrell et al, 2014). Por ejemplo, las personas con Alzheimer pueden modificar su conducta en respuesta a contingencias ambientales, siendo capaces de aprender o re-aprender conocimientos y rutinas procedimentales.…”

Section: Principios De Las Terapias No Farmacológicasunclassified

La persona con demencia y el Museo Nacional del Prado: el arte de recordar

Moratilla-Pérez¹,

Frutos-González²

2017

Arte Individ. Soc.

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Resumen. El presente trabajo describe algunos de los aspectos fundamentales de las actividades dirigidas a público con demencia enmarcadas dentro del proyecto educativo "El Prado para todos", desde la edición 2008-09 hasta el presente. De forma general, el programa cuenta con la participación, cada curso, de 20 centros especializados en el cuidado de personas con trastornos neurodegenerativos. Compuestos de 10-15 usuarios, y acompañados de 2-5 trabajadores del centro, cada grupo toma parte en una experiencia distribuida en dos jornadas diferentes, precedidas por una fase de preparación. Durante la primera jornada, desarrollada en el centro, se hace uso de una proyección de imágenes para captar la atención y estimular cognitivamente a los participantes. Tras la proyección, se realiza una actividad lúdica o creativa. Durante la segunda jornada, en el Museo, se exploran in situ las obras tratadas en la sesión anterior. Después de la visita al Museo se invita a los centros participantes a elaborar trabajos relacionados con la experiencia. Estas obras son publicadas en un micrositio de Internet y han dado lugar, hasta el momento, a dos exposiciones celebradas en Madrid durante el año 2016. Palabras clave: Arte; demencia; Museo del Prado; terapias; exposición.[en] The person with dementia and The Prado Museum: the art of remembering Abstract. This paper describes some of the fundamental aspects of the activities designed for people with dementia within the educational project "The Prado for all", from 2008-09 to the present. Typically, 20 centres specialized in the care of neurodegenerative disorders take part in the programme each year. Composed of 10-15 service users and 2-5 centre workers, the groups participate in an experience divided in two separate days/sessions, preceded by a preparation phase. In the first session, carried out in the centre, a Powerpoint presentation is used to capture the attention of the participants and stimulate them cognitively. After the presentation, a recreative or artistic activity is proposed. In the second session, developed in the Museum, the group explores in situ the artworks treated in the first session. After the Museum visit, participating centres are invited to elaborate a work related to the experience. These works are published in an Internet microsite and have been used, so far, to hold two exhibitions in Madrid during 2016.

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

Abstract: Continuing CST improves quality of life; and improves cognition for those taking AChEIs.

Cited by 139 publications

References 35 publications

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation

Individual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial

La persona con demencia y el Museo Nacional del Prado: el arte de recordar

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