Examining the Feasibility and Acceptability of Digital Cognitive Stimulation Therapy for Dementia Care in Jordan: A Qualitative Study.

Introduction: The use of technology to deliver psychosocial interventions such as cognitive stimulation therapy (CST) to individuals with dementia may improve their cognition and quality of life. Objectives: This study aimed to investigate the participants' experiences with digital CST in Jordanian care homes, as well as the acceptability of the digital CST intervention in Jordanian care homes and recommendations for refinement. Methods: A qualitative study design and semistructured interviews were used to obtain data from 20 people with dementia and 12 care home staff who were purposefully selected. Data were analyzed thematically and comparatively to explore the experiences and outcomes of the participants. This study was conducted from February to April 2023. Results: Analysis of care home staff and residents' experiences revealed seven major themes: (a) personalized support and engagement, (b) positive impact on quality of life, (c) engagement and meaningful activities, (d) adaptable format and accessibility, (e) emotional connection and empowerment, (f) caregiver involvement and support, and (g) suggestions for improvement. The study's findings emphasize the necessity of tailored support, individualized difficulty levels, individualized material selection, emotional support, greater social connection, and caregiver participation in digital CST for people with dementia. Conclusion: Using digital touchscreen technology to deliver CST content has shown potential improvements, making interventions simpler for staff and more beneficial for individuals with dementia, thereby enhancing cognition and quality of life.

Preliminary feasibility study of a cognitive stimulation therapy programme for older adults with an intellectual disability.

BACKGROUND: Despite the increased risk for people with an intellectual disability developing dementia, post-diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing. METHODS: Five client participants attended a 14-session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives. RESULTS: Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers. CONCLUSION: Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence.

The effect of cognitive stimulation therapy on daily life activities, depression and life satisfaction of older adults living with dementia in nursing home: Randomized controlled trial.

OBJECTIVES: In this research, it was aimed to evaluate the effects of Cognitive Stimulation Therapy on activities of daily living, depression, and life satisfaction in older adults with dementia in nursing homes. METHODS: It is a randomized controlled experimental study. The study consisted of a total of 60 older adults, 30 in the intervention group and 30 in the control group, in two different nursing homes. RESULTS: In the post-CST comparison, BADLI posttest measurements, IADLS posttest, follow-up test measurements (p < .001, Fr = 45.982, Fr = 42.54) and SWLS posttest (p < .001, Fr = 38.47) of the individuals in the intervention group measurements were significantly higher. The mean depression level of the CSDD posttest and follow-up test intervention group was significantly lower (p < .001, F = 0.402). CONCLUSION: It was found that Cognitive Stimulation Therapy is effective in increasing the levels of daily life activity and life satisfaction and reducing the level of depression in older adults with dementia. It is recommended to be used by psychiatric nurses.

Effects of a Taiwanese Adaptation of the Group Cognitive Stimulation Therapy Program on Mild-To-Moderate Dementia: A Quasi-Experimental Trial.

Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up.

Effectiveness of Cognitive Stimulation Therapy (CST) for mild to moderate dementia: A systematic literature review and meta-analysis of randomised control trials using the original CST protocol.

AIMS: We aimed to conduct a systematic literature review and meta-analysis to evaluate the efficacy of the original 14 session Cognitive Stimulation Therapy (CST) protocol in improving cognitive function and related outcomes in people with mild to moderate dementia. METHODS: Four databases were searched, up to May 2023, for randomized controlled trials of CST using the original protocol. Pre- and post-test means and measures of dispersion for intervention and control groups were extracted for each reported outcome and used to calculate effect sizes. Effect sizes were grouped by outcome and pooled in inverse variance weighted random effects models. RESULTS: Twelve studies were identified as meeting inclusion criteria. Of these, ten were given either a 'high' or 'medium' quality rating. The pooled results indicated that CST had a significant beneficial impact on global cognition, language, working memory, depression, neuropsychiatric symptoms, communication, self-reported quality of life and severity of dementia. CONCLUSIONS: CST as delivered in adherence to the original 14-session protocol is an efficacious treatment for mild to moderate dementia with improvements in cognition, affective symptoms and quality of life demonstrated from global trials.

The Impact of Exercise and Cognitive Stimulation Therapy on Intrinsic Capacity Composite Score in Pre-Frail Older Adults: A Pre-Post Intervention Study.

Intrinsic capacity(IC) is a measure of physical, cognitive, vitality, psychological, and sensory abilities which determines functional ability. Decline in IC has been shown to accelerate the trajectory of frailty. We aim to show the impact of exercise (Ex) and cognitive stimulation therapy (CST) on (i) IC domains and composite score (ii) frailty and functional ability in pre-frail older adults. Secondary analysis of data from a pre-post intervention study of pre-frail older adults ≥ 65 years attending primary care clinic. Control (CON) and 2 intervention groups ((i) Ex 6 months (ii) CST 3 months with Ex 6 months (Ex+CST)) were recruited. Pre-frailty was determined using the FRAIL scale. Questionnaires (on demographics, functional ability, and depression) were administered and physical function assessment (gait speed (GS), short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted at 0, 3, 6 and 12 months. Four domains of IC were evaluated: locomotion (GS and 5x-STS), vitality (nutrition and muscle mass), cognition (MoCA and subjective cognitive decline) and psychological (depression and anxiety). Each domain was scored from 0 to 2 (no decline) with total IC score ranging from 0 to 8. 187 participants completed baseline and 3 months assessments, 109 (58.3%) were allocated to CON, 37 (19.8%) to Ex and 41 (21.9%) to Ex + CST groups. At 3 months, both Ex and Ex +CST showed improvement in IC composite scores, locomotion, and psychological domain scores but improvement in cognition domain only in Ex + CST group. At 6 months, there were improvements in total IC score, locomotion, vitality, and psychological domain in both Ex and Ex + CST groups. At 12 months, significant improvement was evident in total IC score for Ex and Ex+CST groups, vitality when fatigue (in addition to muscle mass and nutrition) was added and instrumental activities of daily living. Multidomain intervention incorporating exercise and CST resulted in significant improvement in IC composite scores, locomotion, vitality, cognition, and psychological domains.

Effectiveness of Roy Adaptation Model-Based Cognitive Stimulation Therapy in Elderly Patients with Non-Small Cell Lung Cancer Undergoing Curative Resection.

This study aimed to investigate the effects of a Roy adaptation model (RAM)-based cognitive stimulation therapy (CST) intervention on elderly patients diagnosed with primary non-small cell lung cancer (NSCLC) undergoing curative resection. A total of 280 patients diagnosed with primary NSCLC were randomized into RAM-based CST group and control group. Outcomes were assessed at three intervals: pre-surgery, discharge, and one-month post-discharge. Cognitive function was evaluated using Mini-Cognitive test. Postoperative delirium prevalence was determined within 48 hours post-surgery using Nursing Delirium Screening Scale. The Hospital Anxiety and Depression Scale evaluated anxiety and depression symptoms, while Quality of Life (QoL) was assessed via Short Form-36 (SF36) Health Survey. The RAM-based CST group demonstrated significantly higher Mini-Cog test scores than the control group upon discharge and post-intervention. Patients with RAM-based CST exhibited a decrease in postoperative delirium compared to the control group. The RAM-based CST intervention yielded an improvement in anxiety and depression at discharge and 1-month post-discharge compared to preoperative levels. Additionally, the RAM-based CST group exhibited substantial enhancements in SF36 subcategory scores at 1-month post-discharge compared to pre-surgery. At post-intervention, the RAM-based CST group demonstrated significantly higher scores than the control group across various health-related domains, including role limitations due to emotional problems, mental health, general health perception, bodily pain, and role limitations due to physical problems. The RAM-based CST intervention in elderly NSCLC patients undergoing curative resection yielded significant enhancements in cognitive function, reduced delirium incidence, improved emotional well-being, and better QoL postoperatively.

Experiences of cognitive stimulation therapy (CST) in Brazil: a qualitative study of people with dementia and their caregivers.

OBJECTIVES: There is a lack of investment in psychosocial treatments for people with dementia in Brazil. Cognitive Stimulation Therapy (CST) is a group-based intervention that has shown to have benefits on activities of daily living and mood for people with dementia in Brazil. This study aims to explore the experiences and perceived changes following CST groups. METHODS: Individual interviews were conducted with the participants of the group (n = 12) and their caregivers (n = 11). Framework analysis was used to inspect the data. RESULTS: Two main themes have emerged: 'Personal benefits of being part of the group', containing two subthemes: 'Benefits for caregivers' and 'Benefits for person with dementia' and 'Day-to-day changes', containing seven subthemes; 'Memory', Sociability', 'Language', 'Mood', 'Orientation', 'Everyday activities' and 'Behavioural and psychological symptoms'. CONCLUSION: Results suggest that CST groups led to perceived personal benefits for the people with dementia and caregivers and that there are perceived changes for the participants of the groups.

A Single-Blind Randomized Control Trial on the Effectiveness of Adjunct Cognitive Stimulation Therapy on Cognitive Outcomes in Dementia.

Background: Dementia is characterized by neurocognitive decline which interferes with daily function and independence. Cognitive stimulation therapy (CST) is an evidence-based cognitive psychosocial intervention for people with dementia. Materials and Methods: A prospective interventional study of single-blind RCT design conducted in the Department of Neurology at ABVIMS and Dr RML Hospital amongst patients with DSM-V major neurocognitive disorder aged more than 50 years. Participants were randomized to CST and control groups using a block-randomized design. The control group participants received treatment as usual while the CST group delivered 45-min virtual group CST sessions for a total of 14 sessions over seven weeks. All participants in both groups were assessed at baseline and eight weeks using the Montreal Cognitive Assessment Scale (MoCA), Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog), neuropsychiatric inventory, instrumental activities of daily living, and Zarit Burden Interview for Caregiver Burden (ZBI) by a rater blind to group randomization. Results: Total MoCA scores improved significantly in the CST group, compared to the control group which showed a statistically significant decrease. The mean total ADAS-Cog score in the CST group improved significantly compared to controls. The Lawton Instrumental Activities of Daily Living Scale showed a statistically significant change in the control group compared to the intervention group. From the comparison of the mean total neuropsychiatric inventory scale, it was observed that there was a statistically significant decrease in the severity of Behavioural and Psychological Symptoms of Dementia (BPSD) symptoms in the CST group. The mean total ZBI score decreased significantly in the CST group favoring less caregiver burden. Conclusion: This study proved that CST has a significant impact on cognitive outcomes in dementia and it also proved its effectiveness in controlling the BPSD outcomes and caregiver burden in dementia.

Impact of Exercise and Cognitive Stimulation Therapy on Physical Function, Cognition and Muscle Mass in Pre-Frail Older Adults in the Primary Care Setting: A Cluster Randomized Controlled Trial.

OBJECTIVES: Multicomponent exercise program have shown to improve function and cognition in older adults but studies on pre-frail older adults in the primary care setting are limited. This study aimed i) to evaluate impact of 6 months exercise (Ex) versus complementary effect of 3 months of cognitive stimulation therapy (CST) to 6 months of Ex (Ex+CST) on physical function, muscle mass and cognition versus control group at 3, 6 and 12 months ii) inflammatory biomarkers such as Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α). DESIGN: Cluster randomised control trial. SETTING AND INTERVENTION: Pre-frail older adults ≥ 65 years attending primary care clinic. Two intervention groups i) Ex 6 months ii) CST 3 months with Ex 6 months. MEASUREMENTS: At 0, 3, 6 and 12 months, questionnaires (on demographics, physical function, cognition, and depression) were administered and physical function assessment (gait speed, short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted. Muscle mass and its surrogates such as phase angle and body cell mass were measured using bioelectrical impedance analysis machine. Inflammatory biomarkers were measured at 0 and 3 months. RESULTS: Data from 190 participants was analysed at 3 months (111 control, 37 Ex and 41 Ex+CST). At 3 months, significant improvement in cognition was seen only in the Ex+CST group whereas improvements in depression, gait speed, SPPB and 5x-STS were seen in both the Ex and Ex+CST groups. At 6 months, the Ex+CST group improved in cognition and depression whereas improvement in frailty and muscle mass indices were seen in both the interventions groups. At 12 months, both the interventions groups had better perceived health, gait speed and less decline in muscle mass compared with control groups. Both the Ex and Ex+CST had significant association with TNF-α at 3 months (ß -2.71 (95% CI -4.80 - -0.62); p = 0.012 and ß -1.74 (95% CI -3.43 - -0.06); p = 0.043 respectively). CONCLUSION: Combined Ex+CST had significant improvement in cognition whereas the intervention groups improved in depression, physical function, muscle mass, frailty, perceived health and TNF-α levels. With growing evidence of the benefits of multicomponent interventions at primary care level, incorporating it into mainstream care with action plans on long-term sustainability and scalability should be a priority for every country.

Effects of cognitive stimulation therapy on patients with dementia: An umbrella review of systematic reviews and meta-analyses.

BACKGROUND: Dementia is characterized by significant cognitive decline that results in disturbance of daily activities. Increasing number of meta-analyses has examined the efficacy of cognitive stimulation therapy (CST) for dementia. However, there is a lack of comprehensive reports that specifically discuss the strength of evidence to support CST for dementia. PURPOSE: This study aimed to summarize evidence regarding the efficacy of CST on people with dementia. DESIGN: Umbrella review of systematic reviews and meta-analyses. METHODS: We searched Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), and VIP databases from inception to December 31, 2022. The methodological quality of the identified studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Studies scoring 9-12 (moderate quality) points or higher were further analyzed using Grades of Recommendations Assessment, Development and Evaluation (GRADE) principles. RESULTS: A total of 14 systematic reviews and meta-analyses were included in the umbrella review. The methodological quality of most included reviews was rated as moderate according to AMSTAR 2 rating system. In these studies, we summarized the characteristics of the content, providers, frequency, period and setting of CST, and examined eight health outcomes related to CST, including cognition, depression, behavioral symptoms, quality of life (QoL), activities of daily living (ADL), language and communication, anxiety, and memory. Eleven studies with low to high rating of overall confidence (OC) consistently reported that CST could significantly improve cognition of people with dementia, including high-quality supporting evidence. However, the effect of CST on other health outcomes for people with dementia (e.g., depression, behavioral symptoms, QoL, ADL) is inconsistent, with low- to moderate-quality evidence ratings. Compared with the above results, few studies have reported the effects of CST on communication, anxiety, and memory for people with dementia. CONCLUSIONS: In the future, the design and reporting of systematic reviews and meta-analyses should incorporate high-quality research metrics in accordance with AMSTAR 2 criteria. The current review supports CST as an effective treatment for improving cognitive function in patients with dementia. Multi-component interventions are more effective than single-component interventions and need to be delivered regularly. REGISTRATION: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022364259).

Cognitive Stimulation Therapy in a Veteran Sample: A Program Evaluation Study.

OBJECTIVES: Cognitive stimulation therapy (CST) is an evidence-based intervention for dementia. This program evaluation examined the outcomes of a modified CST program in a veteran sample. METHODS: Twenty-five veterans who participated in a once-weekly, 7-week CST program and completed pre/post-group assessments were selected for inclusion in this chart review study. In this diverse sample (Mage = 74.40; 44% White, 44% Hispanic/Latinx, 8% Black, 4% multiracial), most had a suspected neurodegenerative etiology. Paired-samples t-test examined QoL and cognitive pre/post-intervention scores. RESULTS: Statistically significant improvements were observed in RBANS total index scores (Cohen's d = 0.46). Although there was not a statistically significant change in MoCA scores or patient QoL-AD ratings, there were small effects in the predicted direction (Cohen's d = 0.29 and 0.30, respectively). There was no significant change or effect on caregiver QoL-AD ratings (Cohen's d = .09). CONCLUSIONS: A modified, once-weekly 7-week CST program for veterans was feasible and demonstrated positive outcomes. Improvements were observed in global cognition and there was a small, positive effect on patient-rated QoL. Given that dementia is often progressive, stability of cognition and QoL are suggestive of the protective effects of CST. CLINICAL IMPLICATIONS: CST is feasible and beneficial as a once-weekly brief group intervention for veterans with cognitive impairment.

Is Virtual Cognitive Stimulation Therapy the Future for People with Dementia? An Audit of UK NHS Memory Clinics During the COVID-19 Pandemic.

Access to psychosocial interventions for people with dementia, such as Cognitive Stimulation Therapy (CST), has been restricted during the COVID-19 pandemic. Some services have shifted to provision via videoconferencing, but the prevalence of this is unknown. This audit aimed to understand provision of virtual CST (vCST) within National Health Service (NHS) memory clinics throughout the UK and Channel Islands and investigate plans for ongoing CST provision. A cross-sectional survey was circulated to NHS memory clinics, which included closed and open-ended questions to generate quantitative and qualitative data. Thirty-three memory clinics responded to the survey. During the pandemic, 55% of respondents offered vCST, whereas 45% offered no CST. Of those offering vCST, 80% plan to continue with a hybrid model of separate face-to-face and vCST groups, whilst 20% intend to deliver face-to-face CST only. Reported positive aspects of vCST were participant and staff enjoyment, perceived improved digital confidence in participants, and improved accessibility for those who cannot attend face-to-face groups. Negative aspects related to digital poverty, limited digital literacy, support needed from carers, the impact of sensory impairment on engagement, and staff time commitment. Virtual CST has been a feasible alternative to face-to-face services during the pandemic but should not completely replace in-person groups. A hybrid approach would increase accessibility for all. Future research should explore efficacy of vCST and seek to understand patterns of exclusion from such digital interventions. Supplementary Information: The online version contains supplementary material available at 10.1007/s41347-023-00306-5.

Comparisons of Cognitive Stimulation Therapy Between Community Versus Hospital-Based Settings: A Multi-Site Study.

BACKGROUND: Non-pharmacological interventions such as Cognitive Stimulation Therapy (CST) have been shown to help persons living with dementia in improving cognitive function and recall. While previous CST interventions have been conducted largely with community populations, none have explored the outcomes of CST in larger healthcare settings. Our study explored differences of cognitive function, mood, and quality-of-life from CST groups both community and residential-based groups. METHOD: Participants (N = 258) from academic and rural, hospital-based settings in Missouri engaged in 14-session psychosocial groups to aid reminiscence for enhanced cognitive function and recall. RESULTS: Post-intervention cognitive function improvements occurred for community (t = -7.48, p < .001) and residential samples (t = -2.46, p < .05). Community groups showed significant improvement in overall mood related to their dementia (t = 6.37, p < .001). CONCLUSION: Healthcare providers should consider CST as a supplemental intervention for older patients receiving usual care for dementia-related symptoms.

Metacognitive Improvements Following Cognitive Stimulation Therapy for People with Dementia: Evidence from a Pilot Randomized Controlled Trial.

OBJECTIVES: Impaired self-awareness is a common feature of dementia, with considerable clinical impact. Some therapeutic strategies such as cognitive stimulation and psychotherapy have been suggested to mitigate loss of awareness. Nevertheless, evidence of intervention improving awareness of deficits is scarce. The present study aims to explore the impact of a Brazilian adapted version of Cognitive Stimulation Therapy (CST-Brasil), an evidence-based psychosocial intervention for people with dementia (PwD), on the level of awareness, reporting here a secondary outcome of a pilot randomized controlled trial. METHODS: 47 people with mild to moderate dementia attending an out-patient unit were randomly allocated to CST (n = 23) or treatment as usual (TAU) (n = 24) across 7 weeks, in a pilot randomized controlled trial. Awareness was measured before and after the intervention. RESULTS: Results indicated that people in both groups increased in overall awareness of the disease, but only those receiving CST exhibited improvements of awareness of cognitive ability. CONCLUSIONS: These findings suggest that CST may also improve metacognitive abilities in PwD, which could potentially be applied to other settings with beneficial effects. CLINICAL IMPLICATIONS: Considering the negative impacts of anosognosia, CST-led improvements in awareness have the potential to benefit PwD and their caregivers.

Research on the application effect of cognitive stimulation therapy in patients with Alzheimer's disease based on expert consultation and semistructured interviews.

The awareness and utilization of psychological therapies for Alzheimer's disease have increased significantly in recent years. Limitations on the utilization of pharmacological therapy for Alzheimer's disease in China have corresponded with this surge in greater studies in the field. For individuals who have Alzheimer's disease, cognitive stimulation therapy (CST) is a quick self-help that is founded on the theories of quality and cognitive functioning. People with Alzheimer's disease often participate in cognitive behavioral programs; however, their expense has never been studied. Being part of a meta-analysis, we analyze the application effectiveness of a CST program that is based on recent research for Alzheimer's disease patients. A CST group therapy was given to 91 Alzheimer's patients, who resided in healthcare settings or the general public, multiple times per week for 8 weeks; the other 70 people with Alzheimer's disease got a medical therapy. Costs were computed, and resource utilization was tracked for 8 weeks both before and after the therapy. It was determined by a value study. In the value study, cognition and quality of life were the major and tertiary outcomes, respectively. Contours of cost-effectiveness and acceptance were drawn. It was driven based on expert consultation and semistructured interviews. In Alzheimer's disease, CST improves intelligence and standard of living, and there was no difference in implementation expenditures between the categories. Regarding both outcome metrics, there is a significant chance that CST seems to be more expensive than conventional therapy within realistic expectations. The efficacy of CST for Alzheimer's patients is superior to conventional treatment, and it could be the greater value. The outcomes contrast well with pharmacological studies for Alzheimer's. Many people with Alzheimer's disease may benefit significantly from CST groups.

Effectiveness of cognitive stimulation therapy (CST) on cognition, quality of life and neuropsychiatric symptoms for patients living with dementia: A meta-analysis.

INTRODUCTION: Many scholars have explored the effect of cognitive stimulation therapy (CST) on dementia patients, however, due to different experimental designs and insufficient sample sizes, research results are inconsistent. Furthermore, there is a scarcity of high-quality quantitative results. OBJECTIVE: To assess the effectiveness of CST for improving cognition, quality of life (QoL) and neuropsychiatric symptoms in people with dementia (PwD). METHODS: Chinese and English databases were searched for randomized controlled trials (RCTs) between establishment of and April 2022, with another search done in May 2022. Finally, 10 studies on the application of CST in PwD for improving cognition, QoL, behavior, language and activities of daily living were reviewed. RESULTS: Based on the results of the 10 RCTs, CST significantly improved cognitive performance (MMSE: WMD = 1.98, 95% CI: 1.24-2.72, P<0.01), QoL (WMD = 3.12, 95% CI: 2.52-3.72, P<0.01), language (NLT: WMD = 2.71, 95% CI: 1.07-4.35, P<0.01) and activities of daily living (DAD: WMD = 7.27, 95% CI: 0.97-13.56, P<0.01) in PwD. However, no significant improvements in ADAS-Cog (WMD = 0.55, 95% CI: -3.04-4.14, P = 0.76), depression (SMD = -0.12,95% CI: -0.29-0.04, P = 0.15), anxiety (RAID: WMD = -1.05, 95% CI: -3.85-1.75, P = 0.46) or neuropsychiatric symptoms (NPI: WMD = 0.23, 95% CI: -2.62-3.07, P = 0.88) were found. CONCLUSION: CST improved the cognitive ability, QoL, language and activities of daily living of PwD. However, the effect of neuropsychiatric symptoms on PwD requires further exploration.

Effects of cognitive stimulation therapy for people with dementia: A systematic review and meta-analysis of randomized controlled studies.

BACKGROUND: Cognitive stimulation therapy (CST) has been used to improve cognitive function and reduce negative emotions. However, the efficacy of CST among the dementia population remains inconclusive. AIM: To analyze the efficacy of the CST among people with dementia. DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was performed using the Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science databases from the inception to October 18, 2021. The revised Cochrane risk of bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of CST. Stata 16.0 was used for statistical analysis. RESULTS: A total of 26 studies were included. Overall, CST increased cognitive function (standardized mean difference [SMD]: 0.97; 95% confidence interval [CI]: 0.66 to 1.28) and decreased depression (SMD: -0.18; 95% CI: -0.33 to -0.04). No significant effects were found for neuropsychiatric symptoms. CONCLUSIONS: Cognitive stimulation therapy effectively improves cognitive function and alleviates depression levels among people with mild-to-moderate dementia. Futures studies can consider a protocol combined with a rigorous study design to address the effects of CST.

Exploring outcome measures with cognitive stimulation therapies and how these relate to the experiences of people with dementia: A narrative literature review.

A narrative literature review was undertaken to consider the outcome measures used in research on cognitive stimulation therapy (CST), cognitive training (CT) and cognitive stimulation (CS) interventions. This review extends findings from previous reviews by including a broad range of study methodologies, both qualitative and quantitative, and explored whether participant experiences of taking part in the research are discussed. A database search identified 1261 articles matching the search criteria, with 29 included in this review. Studies tended to use the manualised CST model, with 11 other models identified. Randomised control trials were chosen as the most used method to explore impact. Across the studies, 65 different outcome measures were used with people with dementia, and only four studies used a qualitative approach. Little information is provided on the assessment process in terms of time taken, assessor, or of the experience of the person with dementia. There is heterogeneity of measures used, within and across domains, and number, and agreement or consistency of measures would provide greater comparability across CS studies. Gaps in reporting were noted on the detail of the assessment process and the experience of people with dementia taking part in this research.

Cultural Adaptation of Cognitive Stimulation Therapy (CST) for Portuguese People with Dementia.

OBJECTIVES: Portugal is one of the most aged countries in the world and dementia is increasing among the Portuguese population. It is estimated to affect around 200,000 people in Portugal. There is a clear need for non-pharmacological interventions to ameliorate the symptoms of dementia and improve the quality of life. Cognitive Stimulation Therapy (CST), a worldwide well-known program developed in the United Kingdom (UK), is recognized as a cost-effective intervention, with benefits both in cognitive function and quality of life of people with mild to moderate dementia. We tested the feasibility and cultural appropriateness and adapted CST to Portuguese people with dementia. METHODS: The Formative Method for Adapting Psychotherapy (FMAP) model for cultural adaptation was used. A focus group discussion with health professionals and caregivers provided the basis for cultural adaptation, as well as feedback from participants, caregivers, and facilitators after a pilot study. RESULTS: Some modifications were required, especially related to linguistic issues, in 11 of the 14 CST sessions. The adapted program was found to be acceptable and enjoyable in a small sample of people with dementia in a rehabilitation context. CONCLUSIONS: CST seems feasible and culturally appropriate in Portugal. A systematically developed and culturally adapted manual is ready to be used in a large-scale implementation and validation of CST in Portugal. CLINICAL IMPLICATIONS: CST is a valid program for the Portuguese culture, contributes to the availability of a structured and effective clinical intervention for PwD in Portugal and to the possibility of comparing programs across countries.