DELIVERING COGNITIVE STIMULATION WITH TECHNOLOGY

Abstract

Cognitive Stimulation Therapy (CST: Spector, et al., 2003) is a group-based activity for people with dementia using artefacts and music to prompt social interaction that has been shown to deliver significant improvement in cognitive function (+0.9 on MMSE) and quality of life (+1.3 QOL-AD). CIRCA (Computer Interactive Reminiscence and Conversation Aid) is an interactive, multimedia (photographs, music, videos) system to support conversation between people living with dementia and care partners (Astell, et al., 2010). The potential of CIRCA to deliver cognitively stimulating group-based activities has not previously been explored. One hundred people living with dementia are being recruited from 11 sites across Sheffield, UK. Half are using the existing standalone CIRCA device and half a new web-based version. Pre-, post- and three-month follow-up primary outcome measure: Addenbrookes Cognitive Examination-III (ACE-III /100), with QOL-AD (scores 13–52) and EQ-5D (/100) as secondary measures. Thirty-three participants (5M, 28F), 29 living in residential care, have completed the 8-session programme and three-month follow up using standalone CIRCA. They were aged between 69–96 years (mean 85.4) with mean ACE-III scores at baseline of 44.8, mean QOL-AD 30.9 and mean EQ-5D 62.87. Preliminary analysis revealed a significant improvement in cognitive function over the three time points, F(2,64) =4.43, p=0.01), with significant increases from baseline to post-intervention (t=-1.62, p=0.05) which was maintained at 3-month follow up (t=-2.73, p=0.005). There was also a significant increase in quality of life scores over the three time points F(2,64) =4.76, p=-0.01. The data so far support the utility of CIRCA as a tool for facilitating group social activities for people living with dementia, including those with significant cognitive impairment (lower ACE-III scores). Participation in the group sessions lead to improved cognitive scores which were maintained at three months follow up, along with improved quality of life similar to those reported for CST.