Cognitive Stimulation; general, non-specific cognition based practice. It relies upon recall, association and processing. Cognitive training aims to facilitate orientation and affection improvement, among others, depending on each patient’s possibilities.
CST, or 'Cognitive Stimulation Therapy', is a brief treatment for people with mild to moderate dementia. 'Dementia' is an umbrella term, the two main types being Alzheimer's and Vascular dementia. CST was designed following extensive evaluation of research evidence, hence is an evidence-based treatment .UK Government NICE guidance on the management of dementia recommend the use of group Cognitive Stimulation for people with mild to moderate dementia, irrespective of drug treatments received.
The skills and experience of CST group facilitators are integral to the effective running of sessions. There are 18 'Key Principles' which facilitators must incorporate into sessions:
- Mental stimulation
- New ideas, thoughts and associations
- Using orientation, both sensitively and implicitly
- Opinions rather than facts
- Using reminiscence as an aid to the here-and-now
- Providing triggers to aid recall
- Continuity and consistency between sessions
- Implicit (rather than explicit) learning
- Stimulating language
- Stimulating executive functioning
- Maximising potential
- Building / strengthening relationships
Can cognitive stimulation benefit people with dementia?
by Woods B, Aguirre E, Spector AE, Orrell M.
On february 2012 the Cochrane Dementia and Cognitive Improvement Group published an article from Woods B. et al that posed a major question: is Cognitive Stimulation a useful intervention for people with dementia? Read articles summary at Can Cognitive Stimulation benefit people with dementia?
- Woods RT: Reality orientation and staff attention: a controlled study. Br J Psychiatry 1979; 134: 502–507.
- Tárraga L, Boada M, Modinos G, Espinosa A, Diego S, Morera A, Guitart M, Balcells J, Lopez OL, Becker JT: A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer’s disease. J Neurol. Neurosurg. Psychiatry 2006;77:1116-1121
- Baines S, Saxby P, Ehlert K: Reality orientation and reminiscence therapy: a controlled cross-over study of elderly confused people. Br J Psychiatry 1987; 151: 222–231.
- Gerber GJ, Prince PN, Snider HG, Atchinson K, Dubois L, Kilgour JA: Group activity and cognitive improvement among patients with Alzheimer’s disease. Hosp Community Psychiatry 1991; 42: 843–846.
- Breuil V, De Rotrou J, Forette F, Tortrar D, Ganancia-Ganem A, Frambourt A, et al: Cognitive stimulation of patients with dementia: preliminary results. Int J Geriatr Psychiatry 1994; 9: 211–217.
- Robichaud L, Hebert R, Desrosiers J: Efficacy of a sensory integration program on behaviors of inpatients with dementia. Am J Occup Ther 1994; 48: 355–360.
- Bach D, Bach M, Böhmer F, Frühwald T, Grilc B: Reactivating occupational therapy: a method to improve cognitive performance in geriatric patients. Age Ageing 1995; 24: 222–226.
- Spector A, Orrell M, Davies S, Woods B: Can reality orientation be rehabilitated? Development and piloting of an evidence-based programme of cognition-based therapies for people with dementia. Neuropsychol Rehabil 2001; 11: 377–397.
- Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, Orrell M: Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia. Br J Psychiatry 2003; 183: 248–254.
- Knapp M, Thorgrimsen L, Patel A, et al: Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis.Br J Psychiatry 2006; 188: 574–580.
- Politis AM, Vozzella S, Mayer LS, Onyike CU, Baker AS, Lyketsos CG: A randomized, controlled, clinical trial of activity therapy for apathy in patients with dementia residing in long-term care. Int J Geriatr Psychiatry 2004; 19: 1087–1094.
- Onder G, Zanetti O, Giacobini E, Frisoni GB, Bartorelli L, Carbones G, et al: Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomized controlled trial. Br J Psychiatry 2005; 187: 450–455.