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An evaluation of community-based cognitive stimulation therapy: a pilot study with an Irish population of people with dementia

  • M. E. Kelly (a1), S. Finan (a1), M. Lawless (a1), N. Scully (a1), J. Fitzpatrick (a1), M. Quigley (a1), F. Tyrrell (a1), A. O’Regan (a1) and A. Devane (a1)...

Abstract

Objectives

Research shows that cognitive stimulation therapy (CST) improves cognitive function, quality of life, and well-being of people with mild–moderate dementia. Despite consistent evidence and recommendations, CST is not routinely available in Ireland post-diagnosis. The aim of the current research was to develop and evaluate community-based CST for people with mild–moderate dementia, run by the Alzheimer Society of Ireland across four pilot sites in Ireland.

Methods

Participants with mild–moderate dementia attended once weekly CST sessions for 14 weeks. Baseline and post-intervention assessments were completed by CST participants, carers, and CST facilitators. Primary outcomes of interest for CST participants included quality of life (Quality of Life in Alzheimer Disease Scale), cognitive function (Montreal Cognitive Assessment), and subjective cognitive function (Memory Awareness Rating Scale-Functioning Subscale). Secondary outcomes included well-being, cognitive ability, satisfaction with cognitive performance, and engagement and confidence of CST participants; well-being of carers; and job satisfaction of facilitators. Post-intervention interviews supplemented quantitative analyses.

Results

In total, 20 CST participants, 17 carers, and six CST facilitators completed evaluation assessments. Results showed that CST improved participants’ satisfaction with cognitive performance (p=0.002), level of engagement (p=0.046), level of confidence (p=0.026). Improvements on subjective cognitive function just fell short of significance (p=0.055). Qualitative analysis of interview data identified consistent themes of cognitive and overall benefits of CST; and provided support for quantitative data.

Conclusions

Community-based CST positively impacted the lives of people with dementia and their families. This study supports prior recommendations that CST should be made routinely available to people with mild–moderate dementia, particularly in light of the lack of post-diagnostic interventions currently offered in Ireland.

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Copyright

Corresponding author

*Address for correspondence: M. E. Kelly, Department of Psychology, National University of Ireland Maynooth, Room SF21, 2nd Floor John Hume, North Campus, Maynooth, Co. Kildare, Ireland. (Email: Michelle.E.Kelly@nuim.ie)

References

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Agnew, SK, Morris, RG (1998). The heterogeneity of anosognosia for memory impairment in Alzheimer’s disease: a review of the literature and a proposed model. Aging and Mental Health 2, 719.
Aguirre, E, Hoare, Z, Streater, A, Spector, A, Woods, B, Hoe, J, Orrell, M (2012). Cognitive stimulation therapy (CST) for people with dementia – who benefits most? International Journal of Geriatric Psychiatry 28, 284290.
Aguirre, E, Spector, A, Streater, A, Hoe, J, Woods, B, Orrell, M (2011). Making a Difference 2. Hawker Publications: UK.
Aguirre, E, Woods, RT, Spector, A, Orrell, M (2013). Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomised controlled trials. Ageing Research Reviews 12, 253262.
Batsch, N, Miller, RV (2009). An assessment of needs for serving individuals diagnosed with Alzheimer’s disease and related dementias in the early stages. Alzheimer Care Today 10, 140155.
Cahill, S, O’Shea, E, Pierce, M (2012). Creating Excellence in Dementia Care: A Research Review for Ireland’s National Dementia Strategy. Living with Dementia Programme TCD and Irish Centre for Social Gerontology, NUI Galway: Dublin and Galway.
Clare, L (2008). Cognitive Rehabilitation: A Modular Handbook. Psychology Press: Hove, UK.
Clare, L, Linden, DE, Woods, RT, Whitaker, R, Evans, SJ, Parkinson, CH, van Paasschen, J, Nelis, SM, Hoare, Z, Yuen, KS, Rugg, MD (2010). Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. The American Journal of Geriatric Psychiatry 18, 928939.
Clare, L, Whitaker, CJ, Nelis, SM (2010). Appraisal of memory functioning and memory performance in healthy ageing and early-stage Alzheimer’s disease. Aging, Neuropsychology, and Cognition 17, 462491.
Clare, L, Wilson, BA, Carter, G, Roth, I, Hodges, JR (2002). Assessing awareness in early-stage Alzheimer’s disease: development and piloting of the Memory Awareness Rating Scale. Neuropsychological Rehabilitation 12, 341362.
Clare, L, Wilson, BA, Carter, G, Roth, I, Hodges, JR (2004). Awareness in early-stage Alzheimer’s disease: relationship to outcome of cognitive rehabilitation. Journal of Clinical and Experimental Neuropsychology 26, 215226.
Clare, L, Woods, RT, Moniz-Cook, ED, Orrell, M, Spector, A (2003). Cognitive rehabilitation and cognitive training interventions targeting memory functioning in early stage Alzheimer’s disease and vascular dementia. Cochrane Database for Systematic Reviews, article no. CD003260. doi:10.1002/14651858.CD003260.
Coen, RF, Flynn, B, Rigney, E, O’Connor, E, Fitzgerald, L, Murray, C, Dunleavy, C, McDonald, M, Delaney, D, Merriman, N, Edgeworth, J (2011). Efficacy of a cognitive stimulation therapy programme for people with dementia. Irish Journal of Psychiatric Medicine 28, 145147.
Cove, J, Jacobi, N, Donovan, H, Orrell, M, Stott, J, Spector, A (2014). Effectiveness of weekly cognitive stimulation therapy for people with dementia and the additional impact of enhancing cognitive stimulation therapy with a carer training program. Clinical Interventions in Aging 9, 21432150.
de Bettignies, BH, Mahurin, RK, Pirozzolo, FJ (1990). Insight for impairment in independent living skills in Alzheimer’s disease and multi-infarct dementia. Journal of Clinical and Experimental Neuropsychology 12, 355363.
Department of Health (2014). The Irish National Dementia Strategy. Department of Health: Dublin (http://health.gov.ie/wp-content/uploads/2014/12/30115-National-Dementia-Strategy-Eng.pdf). Accessed 22 August 2015.
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.
Gates, N, Valenzuela, M, Sachdev, PS, Fiatarone Singh, MA (2014). Psychological well-being in individuals with mild cognitive impairment. Clinical Interventions in Aging 9, 779792.
Grady, CL, McIntosh, AR, Beig, S, Keightley, ML, Burian, H, Black, SE (2003). Evidence from functional ne uroimaging of a compensatory prefrontal network in Alzheimer’s disease. Journal of Neuroscience 23, 986993.
Health Information and Quality Authority (HIQA) (2008). National Quality Standards for Residential Care Settings for Older People in Ireland. Health Information and Quality Authority (https://www.hiqa.ie/system/files/HIQA_Residential_Care_Standards_2008.pdf). Accessed 16 August 2015.
Hurt, CS, Banerjee, S, Tunnard, C, Whitehead, DL, Tsolaki, M, Mecocci, P, Kloszewska, I, Soininen, H, Vellas, B, Lovestone, S (2010). Insight, cognition and quality of life in Alzheimer’s disease. Journal of Neurological Neurosurgery and Psychiatry 81, 331336.
Knapp, M, Thorgrimsen, L, Patel, A, Spector, A, Hallam, A, Woods, B, Orrell, M (2005). Cognitive stimulation therapy for people with dementia: cost effectiveness analysis. British Journal of Psychiatry 2, 574580.
Kurz, A, Thone-Otto, A, Cramer, B, Egert, S, Frolich, L, Gertz, HJ, Kehl, V, Wagenpfeil, S, Werheid, K (2012). CORDIAL: cognitive rehabilitation and cognitive-behavioral treatment for early dementia in Alzheimer disease: a multicenter, randomized, controlled trial. Alzheimer Disease and Associated Disorders 26, 246253.
Logsdon, RG, Gibbons, LE, McCurry, SM, Teri, L (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging 5, 2132.
Matrix Evidence (2011). An Economic Evaluation of Alternatives to Antipsychotic Drugs for Individuals Living with Dementia. NHS Institute for Innovation and Improvement: Coventry (http://www.institute.nhs.uk/images/Call_to_Action). Accessed 23 August 2015.
Nasreddine, ZS, Phillips, NA, Bedirian, V, Charbonneau, S, Whitehead, V, Collin, I, Cummings, JL, Chertkow, H (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 53, 695699.
National Audit Office (2007). Improving Services and Supports for People with Dementia: Report by the Controller and Auditor General. The Stationary Office: London.
National Dementia Summit Report (2012). Getting on with Life: Our Action Plan for Living with Dementia. Alzheimer Society of Ireland: Dublin.
NICE-SCIE (2007). Dementia: Supporting People with Dementia and their Carers in Health and Social Care: Clinical Guideline 42. The British Psychological Society & the Royal College of Psychiatrists: London.
Onder, G, Zanetti, O, Giacobini, E, Frisoni, GB, Bartorelli, L, Carbone, G, Lambertucci, P, Silveri, MC, Bernabei, R (2005). Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomised controlled trial. British Journal of Psychiatry 187, 450455.
Orrell, M, Aguirre, E, Spector, A, Hoare, Z, Woods, RT, Streater, A, Donovan, H, Hoe, J, Knapp, M, Whitaker, C, Russell, I (2014). Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial. British Journal of Psychiatry 204, 454461.
Perneczky, R, Wagenpfeil, S, Komossa, K, Grimmer, T, Diehl, J, Kurz, A (2006). Mapping scores onto stages: mini-mental state examination and clinical dementia rating. American Journal of Geriatric Psychiatry 14, 139144.
Pierce, M (2012). Post Diagnostic Services and Supports: User Preferences. Living with Dementia Programme Trinity College Dublin (http://dementia.ie/publications/overview/publications-overview). Accessed 8 May 2015.
Prince, M, Bryce, R, Ferri, C (2011). World Alzheimer Report: The Benefits of Early Diagnosis and Intervention. Alzheimer’s Disease International: London (http://www.alz.co.uk/research/WorldAlzheimerReport2011.pdf). Accessed 12 September 2015.
Spector, A, Gardner, C, Orrell, M (2011). The impact of cognitive stimulation therapy groups on people with dementia: views from participants, their carers and group facilitators. Aging and Mental Health 15, 945949.
Spector, A, Orrell, M, Davies, S, Woods, RT (2001). Can reality orientation be rehabilitated? Development and piloting of an evidence based programme of cognition-based therapies for people with dementia. Neuropsychological Rehabilitation 11, 377397.
Spector, A, Thorgrimsen, L, Woods, B, Orrell, M (2006). Making a Difference: An Evidence Based Group Programme to Offer Cognitive Stimulation Therapy (CST) to People with Dementia. Hawker Publications: London.
Spector, A, Thorgrimsen, L, Woods, B, Royan, L, Davies, S, Butterworth, M, Orrell, M (2003). Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. British Journal of Psychiatry 183, 248254.
Streater, A, Spector, A, Aguirre, E, Hoe, J, Hoare, Z, Woods, R, Russel, I, Orrell, M (2012). Maintenance cognitive stimulation therapy (CST) in practice: study protocol for a randomized controlled trial. Trials 13, 91111.
Van Steenoven, I, Aarsland, D, Hurtig, H, Chen-Plotkin, A, Duda, JE, Rick, J, Chahine, LM, Dahodwala, N, Trojanowski, JQ, Roalf, DR, Moberg, PJ, Weintraub, D (2014). Conversion between mini-mental state examination, Montreal Cognitive Assessment, and dementia rating scale-2 scores in Parkinson’s disease. Movement Disorders: Official Journal of the Movement Disorder Society 29, 18091815.
Woods, B, Aguire, E, Spector, A, Orrell, M (2012). Cognitive stimulation to improve cognitive functioning in people with dementia (review). Cochrane Database for Systematic Reviews 2, CD005562, doi: 10.1002/14651858.CD005562.pub2.

Keywords

An evaluation of community-based cognitive stimulation therapy: a pilot study with an Irish population of people with dementia

  • M. E. Kelly (a1), S. Finan (a1), M. Lawless (a1), N. Scully (a1), J. Fitzpatrick (a1), M. Quigley (a1), F. Tyrrell (a1), A. O’Regan (a1) and A. Devane (a1)...

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