Effectiveness of Cognitive Stimulation for Dementia: A Systematic Review and Meta-Analysis.
Cognitive stimulation (CS) is a nonpharmacological intervention often involving group activities and social interaction used to treat cognitive declines in people with dementia. This preregistered systematic review and meta-analysis evaluated the effectiveness of CS in producing benefits on cognitio...
| Publicado en: | Psychological Bulletin Vol. 147; no. 5; pp. 455 - 477 |
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| Autores principales: | , , |
| Formato: | Artículo |
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American Psychological Association
May2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=161853433&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 161853433 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00332909 PSB jtl: Psychological Bulletin issn: 00332909 maglogo: N pubinfo: dt: May2021 vid: 147 iid: 5 pid: 34 pub: American Psychological Association artinfo: ui: 161853433 10.1037/bul0000325 ppf: 455 ppct: 22 formats: tig: atl: Effectiveness of Cognitive Stimulation for Dementia: A Systematic Review and Meta-Analysis. aug: au: Cafferata, Robin M. T. Hicks, Ben von Bastian, Claudia C. affil: Department of Psychology, University of Sheffield Department of Psychology, Centre for Dementia Studies, Brighton and Sussex Medical School su: Activities of daily living Alzheimer's disease Dementia Cognition disorders Language ability testing Geriatric psychiatry sug: subj: Activities of daily living Alzheimer's disease Dementia Cognition disorders Language ability testing Geriatric psychiatry keyword: cognitive decline cognitive stimulation dementia cognitive decline cognitive stimulation dementia ab: Cognitive stimulation (CS) is a nonpharmacological intervention often involving group activities and social interaction used to treat cognitive declines in people with dementia. This preregistered systematic review and meta-analysis evaluated the effectiveness of CS in producing benefits on cognition (primary outcome) and quality of life, activities of daily living, and psychological symptoms (secondary outcomes) across 44 randomized-controlled trials comprising 45 comparisons including 2,444 participants. A medium-sized effect (g =.49) on global cognition was found immediately after the intervention and was supported by decisive Bayesian evidence. Clinical relevance is defined as a reduction of 3 to 4 points on the Alzheimer's Disease Assessment Scale Cognitive subscale; the average attenuation of cognitive decline observed was 2.41 points (after removing 1 outlier). Therefore, the observed decline was of borderline clinical relevance. CS was also found to significantly improve memory, activities of daily living, depressive symptoms, and dementia ratings; most of these effects were supported by substantial and strong Bayesian evidence. No significant effects were found for global cognition at 1 to 10 months follow-up assessment for language, quality of life, anxiety, and behavior symptoms. However, evidence for the absence of these effects was ambiguous. A review of study bias highlighted that most studies lacked active, double-blinded controls, potentially leading to an overestimation of the effect, and making it difficult to conclusively attribute the observed improvements to the CS intervention. Hence, although effects are promising, the methodological issues highlight there is still a need for better controlled studies that provide more compelling evidence. Public Significance Statement: Cognitive stimulation is a psychosocial, nonpharmacological treatment for people with dementia. This meta-analysis of 44 randomized-controlled trials shows that cognitive stimulation does benefit global cognition, memory, activities of daily living, depressive symptoms, and dementia ratings. However, these benefits are of only borderline clinical relevance. Furthermore, our review identifies several methodological challenges that this research area faces, calling for investment into better controlled studies to provide robust and compelling evidence for the effectiveness of cognitive stimulation as a treatment for people with dementia. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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