Cognitive Stimulation as a Therapeutic Modality for Dementia: A Meta-Analysis

Kim, Kayoung; Han, Ji Won; So, Yoonseop; Seo, Ji-Yeong; Kim, You Joung; Park, Joon Hyuk; Lee, Seok Bum; Lee, Jung Jae; Jeong, Hyun Ghang; Kim, Tae Hui; Kim, Ki Woong

doi:10.4306/pi.2017.14.5.626

Cited by 52 publications

(44 citation statements)

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“…Four reviews focused on individuals with MCI (Chandler, Parks, Marsiske, Rotblatt, & Smith, 2016;Sherman, Mauser, Nuno, & Sherzai, 2017;Wang et al, 2014). Ten reviews focused on people with dementia (Alves et al, 2013;Folkerts, Roheger, Franklin, Middelstadt, & Kalbe, 2017;Huntley, Gould, Liu, Smith, & Howard, 2015;Kim et al, 2017;Lee et al, 2019;P. Leung, Orgeta, & Orrell, 2017;Song, Lee, & Song, 2016;Woods et al, 2012).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews

et al. 2020

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Cognition-oriented treatmentscommonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulationare promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of cognition-oriented treatments on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR). We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (mean Hedges' g = 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (mean Hedges' g = 0.40, range 0.32-0.60, five reviews), and dementia (mean Hedges' g = 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (mean Hedges' g = 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of cognition-oriented treatments improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Wang et al, 2016). Three reviews focused on cognitive stimulation (C. Kim et al, 2017;Woods et al, 2012). No review reported meta-analytic results for cognitive rehabilitation.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews

et al. 2020

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“…In all, 34 reviews reported meta-analytical results for CT (Table 1), covering a variety of CT approaches, including computerized training (Gates, Rutjes, et al, 2019;Gates, Vernooij, et al, 2019;Hill et al, 2017;Hoefler, 2016 Wang et al, 2016). Three reviews focused on CS (C. Cooper et al, 2012;Kim et al, 2017;Woods et al, 2012). No review reported meta-analytical results for CR.…”

Section: Interventionsmentioning

confidence: 99%

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Gavelin¹,

Lampit²,

Hallock³

et al. 2019

Preprint

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Cognition-oriented treatments (COTs) -commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation -are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of COTs on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by AMSTAR 2. We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (Hedge's g 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (Hedge's g 0.40, range 0.32-0.60, five reviews), and dementia (Hedge's g 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (Hedge's g 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of COTs improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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“…After an adept clinician detects red flags and takes appropriate steps for diagnosis, an interprofessional team can enable the individual and family members to benefit from a timely diagnosis . Early pharmaceutical intervention for mild dementia can slow the rate of progression . Cognitive stimulation therapy was also shown to slow progression and increase quality of life .…”

Section: Introductionmentioning

confidence: 99%

“…8 Early pharmaceutical intervention for mild dementia can slow the rate of progression. 9 Cognitive stimulation therapy was also shown to slow progression and increase quality of life. 10 Moreover, the person with dementia and his or her caregivers can start to use community resources and training programs to increase safety and quality of life and minimize caregiver strain.…”

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confidence: 99%

Development and Dissemination of an Interprofessional Online Dementia Training Curriculum

Bryan

Asghar-Ali

2019

J American Geriatrics Society

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OBJECTIVES Despite the growing number of individuals with dementia, clinicians skilled in caring for people with dementia, especially in rural areas, are lacking. The Program for Advancing Cognitive Disorders Education for Rural Staff (PACERS) was designed to improve clinician competency and comfort when caring for individuals with dementia. Based on an interprofessional needs assessment, six 1‐hour training modules were created: (1) Dementia and Delirium, (2) Identifying and Assessing for Dementia, (3) Treating Dementia: Case Studies, (4) Normal Cognitive Aging and Dementia Caregiving, (5) Addressing Decision Making and Safety in Dementia, and (6) Dementia and Driving. Each module is available for free on the Department of Veterans Affairs Talent Management System (TMS) for employees and the free TrainingFinder Real‐time Affiliate Integrated Network (TRAIN) platform for clinicians in the community. One continuing education unit is earned upon completion of each module. DESIGN Posttest. SETTING Online training at VA TMS and TRAIN. PARTICIPANTS To date, more than 3000 modules have been completed by interprofessional healthcare learners (eg, nurses, physicians, psychologists, and social workers). MEASUREMENTS Satisfaction, perceived utility of training, knowledge, skills, and attitudes were assessed. RESULTS The learners reported high satisfaction (mean [M] > 4) and ability to apply the knowledge and skills learned from the module to their job (M > 4) on a Likert scale (1 = Strongly disagree to 5 = Strongly agree). CONCLUSION Learners also reported perceived impact on both direct patient care (eg, ability to provide education and support to individuals with dementia and their caregivers) and system‐level care (eg, more appropriate referrals). Given the number of users and their evaluation data, PACERS can serve as a model curriculum for online interprofessional dementia training. J Am Geriatr Soc 68:192–197, 2019

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Cognitive Stimulation as a Therapeutic Modality for Dementia: A Meta-Analysis

Cited by 52 publications

References 61 publications

Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews

Cognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Development and Dissemination of an Interprofessional Online Dementia Training Curriculum

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