Making a Difference with Cognitive Stimulation Therapy: Improving Lives of Individuals with Dementia

Background and Purpose:
With dementia-related disorders being one of the fastest growing chronic diseases in the United States, individuals diagnosed often do not have a voice in their treatment or know how to find effective coping strategies for symptoms. Although medication has traditionally been the primary approach to treatment of early stage dementia symptoms, the effectiveness in reducing memory and cognitive decline is minimal. One approach, Cognitive Stimulation Therapy (CST), shows promise in improving processing and recall for individuals with dementia. This study strives to test the efficacy of CST in improving the lives of individuals with dementia. It is hypothesized that CST will improve cognition, decrease depression, and increase quality of life.

Methods:
This was an exploratory quasi-experiment. Participants identified through community partners (n=84, M=78.84 years old, SD=10.46) underwent CST for seven weeks. Twenty-one participants continued onto maintenance cognitive stimulation therapy. Measures of cognition, depression, and quality of life were taken pre- and post-intervention for participants. Measures of depression and quality of life were taken from a subset of caregivers (n=8). Cognition was measured utilizing the Saint Louis University Mental Status Exam. Depression was measured utilizing the Cornell Scale for Depression in Dementia. Quality of life was measured utilizing the Quality of Life-Alzheimer’s Disease Scale.

Results:
Paired samples t-tests was conducted. There is a statistically significant difference of cognitive scores pre- and post-CST (t₈₀=5.928, p<.001). On average cognition scores were 2.5 points higher post-intervention. A statistically significant difference of Cornell Scale for Depression in Dementia exists (t₈₁=-6.108, p<.001), as well as Quality of life (t₈₁=5.970, p<.001) pre- and post-intervention. The results remained significant when comparing scores at 12 months. No statistically significant differences occur in caregiver quality of life or caregiver depression.

Conclusion and Implications:
With no cure and degenerative in nature, dementia leaves many with not only loss of memory but often autonomy and connection to others. As exhibited by the results, cognition, depression, and quality of life are improved. CST is a means by which participants who experience cognitive impairment ranging from mild to severe dementia have the opportunity to re-engage with their peers and have their voices valued. CST proves to be an effective form of treatment among older adults. These finding support implementation of such non-pharmacological interventions in both community and residential settings. To more fully understand the potential effects of this non-pharmacologic intervention, future research might include utilization of more rigorous trials utilizing a RCT structure and examination of the structural and neurobiological impact of CST through utilization of functional MRIs.