Validation of the cognitive stimulation therapy (CST) program for people with dementia in Portugal

Abstract

Background: Cognitive Stimulation Therapy (CST) is considered a gold-standard, evidence-based and cost-effective approach to improve cognitive function and quality of life of people with mild to moderate dementia.

Aims: To validate CST for the Portuguese population and test its effectiveness.

Methods: A single-blind, multi-center, randomized controlled trial recruited 112 older people with dementia. The primary outcome measure was cognition and secondary measures were quality of life, communication, autonomy, anxiety, depression, and global functioning. We also explored whether CST benefits people differently according to context, gender and level of cognitive reserve.

Results: Fifty-five people were randomized to the intervention and 57 to the control group. In the post-test, the intervention group significantly improved relative to controls in cognition (ADAS-Cog, p = 0.013), communication (HCS, p = 0.045), behaviour (CAPE-BRS, p = 0.017) and in global dementia rating (CDR, p = 0.008). Quality of life, depression and anxiety had no significant differences. The estimated number needed to treat was four for one to benefit a cognitive improvement (ADAS-Cog).

Conclusions: Group CST is valid for the Portuguese population with benefits for people with mild to moderate dementia.

Keywords: Cognitive stimulation therapy; cognition; cognitive stimulation; dementia; non-pharmacological therapy; program validation; quality of life.