Effectiveness of cognitive stimulation for dementia: A systematic review and meta-analysis.
- 1 May 2021
- journal article
- review article
- Published by American Psychological Association (APA) in Psychological Bulletin
- Vol. 147 (5), 455-476
- https://doi.org/10.1037/bul0000325
Abstract
Cognitive stimulation (CS) is a nonpharmacological intervention often involving group activities and social interaction used to treat cognitive declines in people with dementia. This preregistered systematic review and meta-analysis evaluated the effectiveness of CS in producing benefits on cognition (primary outcome) and quality of life, activities of daily living, and psychological symptoms (secondary outcomes) across 44 randomized-controlled trials comprising 45 comparisons including 2,444 participants. A medium-sized effect (g = .49) on global cognition was found immediately after the intervention and was supported by decisive Bayesian evidence. Clinical relevance is defined as a reduction of 3 to 4 points on the Alzheimer's Disease Assessment Scale Cognitive subscale; the average attenuation of cognitive decline observed was 2.41 points (after removing 1 outlier). Therefore, the observed decline was of borderline clinical relevance. CS was also found to significantly improve memory, activities of daily living, depressive symptoms, and dementia ratings; most of these effects were supported by substantial and strong Bayesian evidence. No significant effects were found for global cognition at 1 to 10 months follow-up assessment for language, quality of life, anxiety, and behavior symptoms. However, evidence for the absence of these effects was ambiguous. A review of study bias highlighted that most studies lacked active, double-blinded controls, potentially leading to an overestimation of the effect, and making it difficult to conclusively attribute the observed improvements to the CS intervention. Hence, although effects are promising, the methodological issues highlight there is still a need for better controlled studies that provide more compelling evidence.Keywords
This publication has 74 references indexed in Scilit:
- Cognitive Interventions in Mild Alzheimer's Disease: A Therapy-Evaluation Study on the Interaction of Medication and Cognitive TreatmentDementia and Geriatric Cognitive Disorders Extra, 2013
- Are the effects of a non-drug multimodal activation therapy of dementia sustainable? Follow-up study 10 months after completion of a randomised controlled trialBMC Neurology, 2012
- A Randomized Controlled Trial of Brain-Activating Rehabilitation for Elderly Participants with Dementia in Residential Care HomesDementia and Geriatric Cognitive Disorders Extra, 2012
- Cognitive stimulation to improve cognitive functioning in people with dementiaEmergencias, 2012
- Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomized, controlled trialBMC Medicine, 2011
- What is the clinically relevant change on the ADAS-Cog?Journal of Neurology, Neurosurgery & Psychiatry, 2011
- Effects of reminiscence group in elderly people with Alzheimer disease and vascular dementia in a community settingGeriatrics & Gerontology International, 2007
- Group reminiscence therapy for cognitive and affective function of demented elderly in TaiwanInternational Journal of Geriatric Psychiatry, 2007
- A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer's diseaseJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: a pilot studyClinical Rehabilitation, 2005