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

Xue, Chen

doi:10.1016/j.gerinurse.2022.07.012

Cited by 16 publications

(14 citation statements)

References 40 publications

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“…Remarkably, both groups’ self- and proxy-rated QoL and neuropsychiatric measures were quite homogenous, indicating the reliability of patients’ self-evaluation. These findings are in line with published reviews and meta-analyses reporting that CST effectively improves cognition and QoL in patients with dementia ( Buschert et al, 2010 ; Spector et al, 2012 ; Aguirre et al, 2013 ; Chen, 2022 ; Woods et al, 2012 , 2023 ).…”

Section: Discussionsupporting

confidence: 91%

“…Cognitive stimulation therapy as one of the most popular non-pharmacological approaches comprises various group activities and discussions to enhance the general cognitive and social functioning ( Woods et al, 2012 , 2023 ). Systemic reviews and meta-analyses have provided evidence for significant cognitive improvement induced by CST in mild to moderate AD dementia stages ( Buschert et al, 2010 ; Aguirre et al, 2013 ; Alves et al, 2013 ; Huntley et al, 2015 ; Chen, 2022 ; Woods et al, 2012 , 2023 ). Moreover, for a relatively smaller number of studies, a clinically promoting effect of CST for several outcome measures including quality of life (QoL) has been reported ( Buschert et al, 2010 ; Aguirre et al, 2013 ; Woods et al, 2012 , 2023 ).…”

Section: Introductionmentioning

confidence: 99%

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Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Behfar,

Richter,

Kural

et al. 2023

Front. Aging Neurosci.

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BackgroundDue to the increasing prevalence of Alzheimer’s disease (AD) and the limited efficacy of pharmacological treatment, the interest in non-pharmacological interventions, e.g., cognitive stimulation therapy (CST), to improve cognitive dysfunction and the quality of life of AD patients are on a steady rise.ObjectivesHere, we examined the efficacy of a CST program specifically conceptualized for AD dementia patients and the neural mechanisms underlying cognitive or behavioral benefits of CST.MethodsUsing neuropsychological tests and MRI-based measurements of functional connectivity, we examined the (neuro-) psychological status and network changes at two time points: pre vs. post-stimulation (8 to 12 weeks) in the intervention group (n = 15) who received the CST versus a no-intervention control group (n = 15).ResultsAfter CST, we observed significant improvement in the Mini-Mental State Examination (MMSE), the Alzheimer’s Disease Assessment Scale, cognitive subsection (ADAS-cog), and the behavioral and psychological symptoms of dementia (BPSD) scores. These cognitive improvements were associated with an up-regulated functional connectivity between the left posterior hippocampus and the trunk of the left postcentral gyrus.ConclusionOur data indicate that CST seems to induce short-term global cognition and behavior improvements in mild to moderate AD dementia and enhances resting-state functional connectivity in learning- and memory-associated brain regions. These convergent results prove that even in mild to moderate dementia AD, neuroplasticity can be harnessed to alleviate cognitive impairment with CST.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Behfar,

Richter,

Kural

et al. 2023

Front. Aging Neurosci.

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“…The present study is the first meta‐analysis to confirm this finding. For other outcomes (such as improvement in QoL‐AD, reduction in ADL, and reduction in AES‐C), although several reviews (Brett et al., 2016; Chen, 2022; Woods et al., 2018) have shown that non‐pharmacological treatment (such as cognitive intervention, RT, light) is effective, this was not revealed in this study.…”

Section: Discussioncontrasting

confidence: 55%

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

Yin,

Li,

Bao

et al. 2023

Int J Mental Health Nurs

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Non‐pharmacological interventions can improve the behavioural and psychological symptoms of dementia (BPSD). However, the optimal non‐pharmacological treatments remain controversial. This study aimed to compare the efficacy of multiple non‐pharmacological methods and identify the optimal therapy for BPSD. Potential randomised controlled trials (RCTs) were searched and selected from 15 databases and sources from the inception of the databases until 1 October 2022. Two independent authors implemented study screening, data extraction, and methodological quality assessment. Primary outcome was reduction of Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell Scale for Depression in Dementia (CSDD), the Cohen‐Mansfield Agitation Inventory (CMAI), the Quality of Life in Alzheimer's Disease (QoL‐AD), the Abilities of Daily Living scale, and the Apathy Evaluation Scale. Meta‐analyses were performed using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to evaluate evidence quality. The present study included 43 RCTs with 4978 participants. The global methodological quality of the RCTs was moderate. Regarding NPI reduction, with moderate‐certainty evidence, exercise plus treatment as usual (TAU) outperformed TAU (mean difference [MD]: −7.13; 95% confidence interval [CI]: −13.22, −0.76) and ranked as the optimal treatment. For reduction in CSDD, with low‐ to moderate‐certainty evidence, massage plus TAU (MD: −15.26; 95% CI: −20.13, −10.52) and music plus TAU (MD: −2.40; 95% CI: −4.62, −0.12) were associated with greater reduction compared with TAU. For reduction in CMAI, with moderate‐certainty evidence, aromatherapy plus massage (MD: −15.84; 95% CI: −29.76, −2.42) and massage plus music (MD: −13.12; 95% CI: −25.43, −0.76) were significantly more effective than TAU. For improvement in QoL‐AD, with critically low‐ to low‐certainty evidence, there were no statistical differences between any of non‐pharmacological treatments and TAU. Due to the limited number of included studies, network meta‐analysis was not performed for other outcomes. In conclusion, non‐pharmacological treatments are effective for overall symptoms, depression, and agitation. Exercise plus treatment as usual may be an optimal non‐pharmacological intervention for improving the overall BPSD. This may help to guide patients, doctors, and policymakers.

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“…To date, there are no studies on benefits of CST in pre-frail older adults. CST has largely been studied in persons with dementia ( 40 ) and has been found to be cost effective in improving QoL( 41 ), function and cognition ( 42 ). Our study thus adds to the evidence of the impact that CST and physical exercise has on cognition in pre-frail older adults.…”

Section: Discussionmentioning

confidence: 99%

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

Tan

Chan

Seetharaman

et al. 2023

The Journal of nutrition, health and aging

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

Cited by 16 publications

References 40 publications

Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

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

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