Randomized Controlled Trial of Multi-Component Cognitive Stimulation Therapy (SADEM) in Community-Dwelling Demented Adults

Abstract

Background: Dementia is a persistent, progressive state of cognitive decline against which pharmacological intervention has a modest efficacy, reducing behavioral but not cognitive symptoms. Therefore, different non-pharmacological therapies have been developed; the most scientifically recognized are cognitive therapies that have improved cognitive function and daily life activities. Objective: To evaluate the effectiveness of a multicomponent cognitive stimulation therapy (SADEM) on cognitive and behavioral function and daily life activities in patients with mild stage dementia. Methods: Controlled clinical trial with pre- and post-intervention (12 months) and follow-up (24 months after) evaluations. Participants (67) diagnosed with mild dementia were randomly assigned to intervention group (n = 39) or control group (n = 28). The intervention took place throughout one year and consisted of two weekly 90-minute sessions and one more a year after a monthly follow-up. Instruments were used to evaluate outcomes in cognitive, behavioral, and affective domains. Results: The results showed statistically significant differences, with improvement in the cognitive outcomes and the Dementia Index post-intervention (p = 0.01). No progression of the disease was observed at the end of the study. Conclusion: The multicomponent intervention tested had positive effects on cognitive and behavioral functions and daily life activities in people with mild stage dementia, delaying progression for at least two years.

Effects of Malaysian Cognitive Stimulation Therapy (CST-M) for older people with mild dementia

“…Previous randomised controlled studies and meta-analysis of randomised controlled studies indicate that the CST improve cognitive functions (Woods et al, 2012;Aguirre et al, 2013;Lin et al, 2018;Sarageh et al, 2022), Mood (Yamanaka et al, 2013) and quality of life (Yamanaka et al, 2013;Lin et al, 2018) and the effect can be maintained after three months (Lin et al, 2018). In addition, CST could reduce depression among older people with dementia (Sarageh et al, 2022;Alvares-Pereira et al, 2020;Capotosto et al, 2017;Juárez-Cedillo et al, 2020). Furthermore, data from qualitative studies indicate that the group CST improve social interaction, interconnection, happiness, sense of togetherness and enrichment (Lauritzen et al, 2022;Morrish et al, 2022).…”

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

“…Therefore, it is astonishing that there is a lack of studies on communication-based interventions in dementia [ 297 , 304 ]. Language and/or communication functions are rarely assessed as specific outcome parameters [ 25 , 288 , 290 , 305 , 306 , 307 ] or rather represent higher cognitive functions as fluency tasks [ 306 , 308 ]. Table 2 provides an overview of cognitive language and communication difficulties and resources as AD progresses.…”

“…The systematic review by Lobbia et al [ 290 ] showed moderate evidence for CST on language production and comprehension, communication skills and quality of life for people with mild to moderate AD, partly even with long-term-effects in studies published after this review [ 305 , 306 ]. These beneficial effects can possibly be attributed to the focus of CST on language activities and communicative interaction between group participants [ 290 , 309 ].…”

Personalized treatment interventions: nonpharmacological and natural treatment strategies in Alzheimer’s disease

“…The aim of intervention for MCI is to decrease the rate of conversion from MCI to AD [85]. Strikingly, in MCI, music therapy had the highest probability of being the best treatment for global cognition, followed by acupuncture and then exercise, among potential pharmacological (including AChE inhibitors) and nonpharmacological treatments, but cognitive interventions were not included [64].…”

“…The aim of the treatment in the mild-to-moderate phase is to preserve cognition and delay disease progression as much as possible. For example, multicomponent cognitive stimulation in participants with mild-stage dementia had not only positive effects on cognition and behavior but also delayed disease progression for at least two years [85]. The combination of several modalities was also effective; for example, in individuals with predominantly mild AD, an integrated program focused on cognitive training, art therapy, and music therapy improved multiple domains such as cognition, depression, anxiety and activities of daily living [86].…”