Cognitive Stimulation Therapy Group Research Articles

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.

Impact of Infection Control Measures on Effectiveness of Cognitive Stimulation Therapy

AbstractBackgroundPeople living with dementia are at higher risk of contracting and dying from SARS‐CoV‐2. Protection measures such as wearing a mask remained necessary in dementia service facilities, despite their limiting effects on communication and interactions. Their impacts on existing evidence‐based psychosocial interventions offered in these facilities, such as Cognitive Stimulation Therapy (CST), are yet unknown.MethodMixed‐methods study using data from a larger randomised controlled trial partially disrupted by the COVID‐19 pandemic. People with mild or moderate dementia randomised into receiving CST (n = 72) were compared with those receiving usual care (n = 72) for cognitive (ADAS‐Cog) and quality of life (QoL‐AD) changes. To investigate the impact of infection control measures on CST effectiveness, interaction effect between timing of enrolment (before vs after COVID‐19 outbreak) and intervention group was tested. Focus groups were conducted with persons with dementia who have received CST and their families (n = 22).ResultParticipants who received CST reported better quality of life (B = 4.195, F = 28.159, p <0.001) compared with those who received usual care, controlling for demographics and antidementia medications. For cognition, an interaction effect was observed (F = 4.557, p = 0.036) between timing of enrolment and group. CST maintained cognition only in groups before COVID‐19 outbreak (marginal means of ADAS‐Cog improvement: +0.453 in CST vs ‐1.465 in usual care) but not in groups after the outbreak (‐2.104 vs +0.716). Persons living with dementia and their families reported difficulties hearing, being heard, recognising and interacting with other CST group members, and reduced efforts in participation due to discomfort wearing a mask,ConclusionInfection control measures may reduce the cognitive benefits of CST, which may be due to their effects on speech intelligibility and other interactions in a psychosocial intervention group. In the post‐COVID era, alternative measures such as virtual CST delivered via an online meeting platform should be investigated.

Virtual Cognitive Stimulation Therapy for dementia: The development, feasibility and initial outcomes of a global framework

AbstractBackgroundGroup Cognitive Stimulation Therapy (CST) is the most widely implemented post‐diagnostic intervention for dementia in the UK (Perkins et al, 2022). This presentation describes the development and initial testing of a virtual group Cognitive Stimulation Therapy (vCST) programme for people with dementia, developed as a result of services moving online during the COVID‐19 pandemic and a general increase in teletherapies.MethodThe vCST protocol was developed using the existing group CST manual, through stakeholder consultation with people living with dementia, caregivers, CST group facilitators and dementia service managers. This protocol was then field‐tested with ten groups of people living with dementia in the Brazil, China (Hong Kong), India, Ireland and the UK, and feedback on the protocol was gathered from 14 facilitators. Finally, the vCST programme was delivered to people with dementia in India (n = 15), Brazil (n = 44) and the UK (n = 24).ResultsField testing in five countries indicated acceptability to group facilitators and participants. Feedback from these groups was used to refine the developed protocol. Initial qualitative findings from the UK study and quantitative findings from India, Brazil and the UK will be presented, demonstrating the feasibility, acceptability and perceived benefits of these virtual groups.ConclusionThe final vCST protocol is proposed, including session materials for delivery of CST over video conferencing and a framework for offering CST virtually in global settings. vCST is an acceptable online intervention for many people living with dementia globally. We recommend that it is offered to those unable to access traditional in‐person CST, for example for health reasons and lack of transport or COVID‐19 restrictions. Many services have indicated plans to continue vCST long‐term, hence further research is needed to explore if participant outcomes are comparable to in‐person CST groups.Reference: Perkins, L., Fisher, E., Felstead, C., Rooney, C., Wong, G. H., Dai, R., … & Spector, A. (2022). Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field‐Testing a New Framework. Clinical Interventions in Aging, 17, 97.

Service users’ experience of a Cognitive Stimulation Therapy group on a dementia acute inpatient ward

Cognitive Stimulation Therapy (CST) aims to stimulate and support cognitive abilities, as well as engage people living with dementia in a fun and inclusive activity. CST also has a growing evidence base in improving cognitive functioning and quality of life for people living with dementia. A CST group was set up on a dementia inpatient ward to explore if the benefits in previous research could be replicated in an inpatient setting. The CST group ran once a week for approximately one hour which was facilitated by the ward assistant psychologist and activity facilitator. The evaluation of the group indicates services users found the sessions to be inclusive, thought provoking, cognitively stimulating and enjoyable.

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

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. 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. 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. 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.

INCORPORATING SPIRITUALITY INTO COGNITIVE STIMULATION THERAPY GROUPS FOR PERSONS WITH DEMENTIA

Abstract With the rise in Dementia-Related Disorders globally, few non-pharmacological approaches have been developed to effectively target cognitive impairment and memory loss. Cognitive Stimulation Therapy (CST) has shown effectiveness in improving cognition and quality of life of older adults with dementia. To date, no studies have incorporated spirituality into CST for improving the cognition and quality of life of older adults with dementia. This study’s aim is to evaluate the effectiveness of CST with a spirituality component compared to the traditional CST group intervention. Our team grouped participants (Nf34) into either spiritual or traditional groups based on their location of residence and level of cognition. Preliminary results showed that spiritual-themed groups improved in mental health status, mobility, and depression. The spiritual groups had a mean difference of 1.85-points improvement on mental status exam as compared to 0.2-point reduction for the traditional groups. In addition, the spiritual groups had a mean difference of 4.80-points improvement in mobility and 0.6-point improvement on depression as compared to a 5.25-points reduction in mobility and a 2.13-points reduction on depression of the traditional groups respectively. Compared to the traditional CST group, there were no significant differences noted regarding cognition and memory recall. Incorporating spirtiuality and other faith-based themes in groups may provide additional benefit for individuals with memory loss. Both healthcare and long-term care facilities may benefit from incorporating group interventions such as CST into their routine care with older adults.

A-116 Impact of Cognitive Stimulation Therapy on Cognitive Functioning and Quality of Life in a Veteran Population

Abstract Objective: Cognitive Stimulation Therapy (CST) is a non-pharmacological intervention for dementia. The CST program developed by Spector and colleagues has proven effective in improving quality of life (QoL) and cognition in older adults with dementia. The purpose of the present study was to examine the effectiveness of CST in a veteran population. Method: A clinic-referred sample of veterans who completed a 7-week CST and pre/post-group assessments were selected for this study. This resulted in a sample of 25 male veterans, a majority of whom were diagnosed with a progressive dementia (Mean age = 74.44; Mean education = 13.7; 44% White, 44% Hispanic/Latinx, 8% Black). Paired-samples t-test were used to determine if group participation was associated with improvements in QoL or cognitive functioning. Results: Veterans who participated in the CST group did not demonstrate a significant change in MoCA scores from pre-test (M = 16.63, SD = 3.28) to post-test (M = 17.42, SD = 4.23), (t[23] = −1.44, p = 0.16, Cohen’s d = 0.296) or RBANS total scores from pre-test (M = 61.73, SD = 10.13) to post-test (M = 64.55, SD = 11.28), (t[21] = −1.89, p = 0.07, Cohen’s d = 0.263). Similarly, there was no significant change in QoL as measured by participants from pre-test (M = 35, SD = 7.60) to post-test (M = 36.22, SD = 7.16), (t[22] = −1.30, p = 0.21, Cohen’s d = 0.165) or as measured by a caregiver from pre-test (M = 30, SD = 7.37) to post-test (M = 28.75, SD = 7.46), (t[19] = 0.69, p = 0.50, Cohen’s d = 0.169). Conclusion: While CST did not significantly improve cognition or QoL in a diverse veteran sample, there was a small effect observed on cognitive functioning. Given that dementia is often a progressive disease, even stability of baseline cognition is suggestive of the protective effect of CST.

Coupling Hearing Health With Community-Based Group Therapy for Cognitive Health in Low-Income African American Elders

Purpose: To address disparities in the domains of hearing health and cognitive health experienced by African American elders in early stages of cognitive-communicative decline, a cognitive stimulation therapy (CST) group was established. The group intervention was coupled with comprehensive audiology services. This clinical focus article describes the features of the program, its implementation, and outcomes from its first cohort of participants. Method: CST is an evidence-based group intervention for elderly individuals living with mild-to-moderate dementia. The program was designed to (a) adapt and then apply CST to a target group of low-income African American elders and (b) integrate audiology services and education about hearing health and hearing loss in the context of CST therapy. In partnership with two community health centers in North St. Louis, a CST group was established for 12 elderly African American clients with cognitive-communicative impairments as measured by standardized assessments. During weekly group sessions, culturally informed activities and discussions were conducted with input from staff and participants to stimulate social interaction and cognition. Health topics relevant to age-related sensory and cognitive decline were introduced, with emphasis on management of common chronic diseases such as diabetes that are known to be associated with increased risk of hearing loss. Free hearing health services were provided, including screenings and, as needed, full audiological evaluations, cerumen management, otolaryngology referrals, hearing aids, and aural rehabilitation. Results: Participants' self-administered ratings and self-generated comments indicated meaningful increases in actionable knowledge about both hearing and cognitive health that led to enhanced utilization of available health services. They also suggested that audiology services were paramount to their enthusiastic adherence to the combined CST–audiology program. Conclusion: Interlinking of interventions for hearing and cognition reduced common barriers to care for this target group of low-income African American elders with cognitive-communicative impairments.

Rehabilitation in dementia: CST and Sonas group interventions for people with moderate cognitive impairment. A pilot study

Purpose Dementia is a complex, progressively degenerative condition. It results in loss of cognitive and functional capabilities, along with a significant increase in the level of dependency. A reduction in the use of pharmacological interventions correlates with an increased in good quality non-pharmacological interventions in dementia care. The purpose of this study is to examine the impact of 14-session face-to-face cognitive stimulation therapy (CST) and Sonas group interventions on individuals living with dementia with moderate cognitive impairment, from pre-intervention to post-intervention in terms of their cognition, communication, neuropsychiatric symptoms, activities of daily living and quality of life. Design/methodology/approach A pilot single blind prospective controlled trial evaluated two group intervention approaches, cognitive stimulation therapy (CST) and Sonas, with 28 participants with moderate dementia. Pseudorandomisation and single blinding were implemented. CST has a solid evidence base. Sonas is a widely used multi-sensory intervention in Ireland with an emerging evidence base. Participants were recruited from a mental health service. Participants who had a formal diagnosis of dementia, moderate cognitive impairment and some ability to communicate and understand communication were included. Findings Results supported CST to a greater extent than Sonas. The CST group showed significant changes in cognition (p = 0.032) and communication (p = 0.006). Both groups had significant changes in carer quality of life (CST, p = 0.019; Sonas, p = 0.035). Results support the recommendations for a future definitive trial. Research limitations/implications Rehabilitation potential of individuals living with moderate dementia was demonstrated. This study suggests that group interventions like these impact on the trajectory of dementia. Practical implications Rehabilitation interventions impact on the trajectory of dementia. CST and Sonas have no impact on activities of daily living. Future studies with larger sample sizes, 16 weeks intervention period and control groups are required. Social implications This pilot study supports CST over Sonas interventions for individuals living with moderate dementia. Multiple outcome measures demonstrated trends towards significance for both interventions. Future definitive trials may detect a significant effect of both interventions. Originality/value A dementia diagnosis is devastating and generally creates negative perceptions and associations (Alvira, 2014). In contrast, the outcomes of this study are positive. This study provides evidence that occupational therapist intervention can impact on the trajectory of the condition with people with dementia demonstrating that they do have rehabilitation potential by responding to treatment and improving and maintaining their abilities as they progress through the condition.

Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework.

PurposeThis feasibility and pilot study aimed to develop and field-test a 14-session virtual Cognitive Stimulation Therapy (vCST) programme for people living with dementia, developed as a result of services moving online during the COVID-19 pandemic.MethodsThe vCST protocol was developed using the existing group CST manual, through stakeholder consultation with people living with dementia, caregivers, CST group facilitators and dementia service managers. This protocol was then field-tested with 10 groups of people living with dementia in the Brazil, China (Hong Kong), India, Ireland and the UK, and feedback on the protocol was gathered from 14 facilitators.ResultsField testing in five countries indicated acceptability to group facilitators and participants. Feedback from these groups was used to refine the developed protocol. The final vCST protocol is proposed, including session materials for delivery of CST over videoconferencing and a framework for offering CST virtually in global settings.ConclusionvCST is a feasible online intervention for many people living with dementia. We recommend that it is offered to those unable to access traditional in-person CST for health reasons, lack of transport or COVID-19 restrictions. Further research is needed to explore if participant outcomes are comparable to in-person CST groups.

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.

Cognitive Stimulation Therapy for People with Parkinson's Disease Dementia

<h3>Research Objectives</h3> To investigate the effect of Cognitive Stimulation Therapy (CST) for people with Parkinson's disease dementia (PDD) and their caregivers. <h3>Design</h3> Within-subjects pre-test post-test design. <h3>Setting</h3> Community-based, in partnership with the local American Parkinson Disease Association chapter. <h3>Participants</h3> Eighteen participants: 9 people with possible PDD (MoCA score < 21), and 9 caregivers. <h3>Interventions</h3> A 7-week program of bi-weekly 45-minute long CST group classes for people with PDD. CST is an intervention for people with dementia involving group activities and conversations that stimulate cognitive and social skills. <h3>Main Outcome Measures</h3> PDD participants completed the Montreal Cognitive Assessment (MoCA), Neuro Quality of Life Cognition Short Form (NeuroQOL Cog SF), Geriatric Depression Scale (GDS), Parkinson's Disease Questionnaire-39 (PDQ-39) and Relationship Assessment Scale (RAS). Caregivers completed the Caregiver Burden Scale (CBS) and RAS. After the course, both groups completed the Client Satisfaction Questionnaire (CSQ-8). <h3>Results</h3> The PDD group's MoCA scores improved from pre to post intervention (pre: M = 19.11, SD = 2.57; post: M = 21.22, SD = 2.95; p = 0.01). All other measures, except the PDD RAS and CBS, showed pre-post improvement, although these were not significant. The PDD participants and their caregivers reported high satisfaction with the program, as indicated by the CSQ-8 (M = 3.5 [out of 4 possible], SD = 0.16), with 72% of participants rating all items positively. <h3>Conclusions</h3> Participation in a group CST course resulted in improved cognition in this small sample of people with PDD. In addition, individuals with PDD and their caregivers were highly satisfied with the program. Although larger studies are needed, these findings suggest that CST may benefit cognition among people with PDD and is an acceptable program for people with PDD and their caregivers. <h3>Author(s) Disclosures</h3> The authors have no disclosures to report.

Changes in Default Mode Network Connectivity in Resting-State fMRI in People with Mild Dementia Receiving Cognitive Stimulation Therapy.

Group cognitive stimulation therapy (CST) is a 7-week activity-based non-pharmacological intervention for people with mild to moderate dementia. Despite consistent evidence of clinical efficacy, the cognitive and brain mechanisms of CST remain unclear. Theoretically, group CST as a person-centred approach may work through promoting social interaction and personhood, executive function, and language use, especially in people with higher brain/cognitive reserve. To explore these putative mechanisms, structural MRI and resting-state functional MRI data were collected from 16 people with mild dementia before and after receiving CST, and in 13 dementia controls who received treatment as usual (TAU). Voxel-based morphometry (VBM) and resting-state functional connectivity (rs-FC) analyses were performed. Compared with TAU, the CST group maintained the total brain volume/total intracranial volume (TBV/TICV) ratio. Increased rs-FC in the default mode network (DMN) in the posterior cingulate cortex and bilateral parietal cortices nodes was observed in the CST over TAU groups between pre- and post-intervention timepoints. We provided preliminary evidence that CST maintains/enhances brain reserve both structurally and functionally. Considering the role of DMN in episodic memory retrieval and mental self-representation, preservation of personhood may be an important mechanism of CST for further investigation.

Cognitive stimulation therapy for people with mild to moderate dementia in a day hospital setting: a service evaluation

Background/Aims The National Institute for Health and Care Excellence guidelines for dementia recommend the use of cognitive stimulation therapy as a non-pharmacological treatment for people with mild to moderate dementia. Research evidence indicates that it can have a positive impact on cognition, quality of life and mood. Methods Cognitive stimulation therapy groups have recently been delivered as part of a therapeutic programme at a day hospital and a service evaluation was conducted to ascertain the impact of cognitive stimulation therapy on the patients attending these groups. The cognitive functioning and mood of patients was assessed before and immediately after a course of 14 cognitive stimulation therapy group sessions using the Montreal Cognitive Assessment and the Geriatric Depression Scale. Results The results indicated a stabilisation or improvement in cognition in eight of the nine patients and an improvement in mood in five of the nine patients. Conclusions These findings are in line with current research and support the continued use of cognitive stimulation therapy in the day hospital.

An Age-Friendly Health System.

To describe a screening and intervention program for geriatric syndromes instituted at a rural healthcare system that utilizes the 4Ms of an age-friendly health system, and to provide exercise and cognitive stimulation therapy (CST) as part of an age-friendly health program. Retrospective evaluation of clinical data. Rural primary healthcare system. Older adults aged 65 years and older in Perry County, Missouri. Screening for geriatric syndromes was done using the Rapid Geriatric Assessment (RGA), which includes the FRAIL, SARC-F, Simplified Nutritional Appetite Questionnaire (SNAQ), and Rapid Cognitive Screen (RCS). Outcomes for exercise and CST included the Five Times Sit to Stand (FTSS) and Timed Up and Go (TUG) tests, Cornell Scale for Depression in Dementia (CSDD), Saint Louis University Mental Status Examination (SLUMS), and Quality of Life in Alzheimer's Disease (QoL-AD) measures. The RGA was administered to 1,326 individuals of which 36.5% were frail, 42.1% were sarcopenic, 26.1% were at risk for anorexia, and 20.8% had dementia. Of these receiving exercise therapy, both the FTSS and the TUG were improved at 3 months and 12 to 24 months. In the CST group, SLUMS, QoL-AD, and CSDD were improved at 7 weeks and 6 to 12 months. It is feasible to introduce a screening program for geriatric syndromes and respond to the results with successful exercise and cognitive stimulation therapy programs.

The Outcomes of Cognitive Stimulation Therapy (CST) for Community-Dwelling Older Adults With Cognitive Decline in Taiwan

Aim: To assess the impact of cognitive stimulation therapy (CST) on cognition, quality of life, and mood in Taiwanese elders with cognitive impairment attending a day care center. Methods: Twenty-five adults aged 65 years and older were assigned into the CST (n =12) and control (n = 13) groups. Weekly 90-minute CST sessions for 14 weeks were conducted by occupational therapists and occupational therapist students. The Alzheimer's Disease Assessment Scale—Cognitive subscale (ADAS-Cog), the Quality of Life in Alzheimer's Disease (QOL-AD), and the Hospital Anxiety and Depression Scale (HADS) were used for pre- and posttest measurements. Within- and between-group comparisons of test scores were performed. Results: Significant between-group differences were found for the ADAS-Cog change scores. Specifically, there was significant cognitive improvement for participants in CST group at posttest, with no observable change for the controls. No significant pre-/postgains were noted in the QoL-AD and HADS scores for the 2 groups. Conclusion: The once-a-week CST approach seems to be a viable alternative to twice-a-week CST for community-dwelling older adults with mild to moderate cognitive deficits. Further investigation is required to determine the optimal dose of CST for the elderly.

Outcomes of Expanded Cognitive Stimulation Therapy Group for Mild-Stage Dementia: Four-Month Follow-Up

Purposes:This research aims to report the results of a 4-month follow-up study of an expanded cognitive stimulation therapy (CST) group that combines CST and Tai Chi on improving the cognitive abilities of community-dwelling Chinese elderly with mild-stage dementia (EwMD).Methods:Two-group pretest–posttest design was adopted in this study, involving 101 Chinese community-dwelling EwMD who had completed an expanded CST group conducted at a local elderly center. Cognitive abilities of the EwMD were assessed by standardized assessment tools at pretreatment (T1), posttreatment (T2), and the 4-month point after completion of treatment (T3).Results:The repeated-measures analysis of variance showed that after completing the expanded CST group, the improved cognitive abilities of participants could be maintained up to 4 months after the completion of treatment.Conclusions:This study demonstrated that treatment effects of the expanded CST group could be maintained up to 4 months after completion of treatment.

IMPROVING CAREGIVER WELL-BEING THROUGH COGNITIVE STIMULATION THERAPY GROUPS FOR INDIVIDUALS WITH DEMENTIA

AbstractIntroductionAlthough medication has traditionally been the primary approach to treatment symptoms of dementia, caregivers lack other services to help their loved ones with the disease. What is also lacking are ways to improve caregivers’ well-being while attending to the individual with dementia. This study explored whether an evidenced based treatment for memory improvement for individuals with dementia helps improve caregiver well-being over time.MethodsData was taken from Cognitive Stimulation Therapy (CST) groups that were conducted at a university-based clinic. The Rapid Caregiver Well-Being (RCWB) Scale was administered both at baseline and session 14 of the study for three groups. Participants were recruited from primary care clinics, geriatric clinics, the Alzheimer’s Association and a student-led community health clinic.ResultsResults revealed that 14 of the 28 participants (50% fidelity) had completed the 14 sessions across the study, with the same activities and protocol across each study. A one-way ANOVA revealed that RCWB scores increased by an average of two points from baseline to session 14 for this sample (<.05). There were no statistically significant differences found between each CST group on the RCWB.DiscussionCST could be a sustainable option for older adults with memory problems that need meaningful activities during the early years of the diagnosis. Additionally, caregiver receive respite care during these groups, where their overall well-being can show improvements over time. Medical centers should recognize the utility of CST and how more group interventions are needed following a diagnosis by a physician or geriatrician.

The effects of an expanded cognitive stimulation therapy model on the improvement of cognitive ability of elderly with mild stage Dementia living in a community — a randomized waitlist controlled trial

ABSTRACTObjective: This research study aims to evaluate the effectiveness of an expanded cognitive stimulation therapy (CST) model that combines a CST group and tai chi on improving the cognitive ability of community-dwelling Chinese elderly with mild stage dementia (EwMD).Method: A randomized waitlist controlled trial design was adopted in this study. The treatment group participated in a structured CST group followed by tai chi twice a week, with a total of 14 sessions throughout the study period. The waitlist control group received treatment as usual at the initial stage and expanded CST model at a later stage. The Chinese Mattis Dementia Rating Scale (DRS) and the Chinese Mini Mental State Examination (MMSE) were used to assess the cognitive ability of EwMD in the pre- and post- treatment periods.Results: At baseline, the treatment group (n = 51) and control group (n = 50) did not differ significantly in any demographic or clinical variables. Overall, the participants had a mean baseline MMSE score of 20.67 (SD = 2.30). The 2 × 2 repeated measures ANCOVA demonstrated that the treatment group was significantly more effective than the control group in improving the MMSE score (F = 12.31, p< .01) with a moderate effect size (partial eta square = .11) after controlling for group difference in age, gender, education, and having a diagnosis of dementia.Conclusion: The present study demonstrates the effectiveness of the expanded CST model on the improvement of cognitive ability of community-dwelling EwMD. More research is needed to further investigate this intervention model across cultures and societies.