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Cognitive stimulation therapy is a group-based psychological treatment for people with dementia as well as those with mild cognitive impairment (MCI) and is shown to improve both cognition and quality of life. Previous studies have indicated the potential to benefit from the use of technological devices in group interventions. The pilot study aimed to assess the effectiveness of a tablet- and group-based multicomponent cognitive stimulation therapy (MCST) for enhancing cognitive functions among older adults with MCI. The following study aims to report the protocol for a trial evaluating whether the MCST program is affecting individuals with MCI. In the first study, 30 individuals with MCI participated in 10 sessions of the tablet- and group-based MCST group. A subsequent protocol study will compare tablet-based MCST, tablet-based cognitive stimulation therapy, and control groups among 93 individuals with MCI. All participants will be recruited from older adults living in semiurban communities. Intervention groups will be facilitated by trained therapists, nurses, or psychologists. The study will be assessed by a pre- and posttest evaluation, including computer-based neuropsychological tests and electroencephalography assessment. The effects of several indicators, such as cognitive functions, behavioral, and emotional, will be analyzed as being indexed by their neurophysiological data. The pilot study showed significant cognitive improvement (P<.001), reduced depression (P=.002), and decreased state anxiety (P=.001) post intervention. Quality of life remained unchanged (P=.18). The randomized controlled trial study was funded in March 2023. Enrolling began in August 2023 and was completed in December 2023. The data analysis was started, and the results are expected to be published by mid- to late-2025. The study is the first tablet-group-based MCST for older adults with MCI in middle-income countries. It will provide deeper insight into participants' neuropsychological data, thus identifying specific processes underlying physiologically measured positive outcomes. Furthermore, the project will deliver solid and integrative results to mental health professionals in terms of knowledge and guidance for implementing the tablet- and group-based MCST in people with MCI. Thai Clinical Trials Registry TCTR20230829004; https://tinyurl.com/3wuaue3e. DERR1-10.2196/64465.

We investigate the effectiveness of three types of IT-enabled cognitive stimulation tools for enhancing creative problem solving: mind mappers, process guides, and stimuli providers. Based on the dual pathway to creativity models, the authors examine the extent to which these tools are capable of stimulating individuals to explore their knowledge base more deeply (i.e., the persistence pathway) and more broadly (i.e., the flexibility pathway) and, hence, help to produce more novel ideas. In a laboratory study with business students, they find that, as compared to unaided individuals, IT-enabled stimuli providers enhance individual creativity more than process guides and mind mappers. As for the underlying creative process, stimuli providers push individuals to explore their knowledge base more deeply and more broadly, leading to more novel but, unexpectedly, also more useful ideas. The reported findings may facilitate the development of creativity support systems and their assignment to individuals and tasks.

ABSTRACTBackgroundCognitive stimulation therapy (CST) is an evidence-based, cost-effective psychosocial intervention for people with dementia but is currently not a standard part of post-diagnostic care. This qualitative study explored the views and experiences of dementia care providers on the barriers and facilitators to its implementation in usual care. MethodThirty four semi-structured interviews (24 participants) were conducted across four dementia care sites in the North of England; ten were follow-up interviews. Data were analyzed using thematic analysis and then mapped to the Normalization Process Theory framework. ResultsParticipants considered CST a “good fit” with their “preferred” ways of working and goals of dementia care namely the provision of person-centered services. For facilitators delivering the intervention, compared to other behavioral interventions, CST was seen to offer benefits to their work and was easy to understand as an intervention. Training in CST and seeing benefits for clients were important motivators. Time and resources were crucial for the successful implementation of CST. Participants were keen to objectively measure benefits to participants but unsure how to do this. ConclusionsCST is a cost-effective psychosocial intervention for people with dementia, recommended by national guidance. Despite our findings which show that, using the NPT framework, there are more facilitators than barriers to the implementation of CST, it is still not a standard part of post-diagnostic dementia care. Further research is needed to explore the reasons for this implementation gap in ensuring evidence-based care in translated into practice.

PurposeThe development and clinical application of digital devices to support individuals with dementia can be challenging due to difficulties meeting the needs of a patient population with largely heterogeneous and progressive symptoms. Memjo Ltd has developed a digital interactive prototype tablet to promote cognitive stimulation and reminiscence. This proof-of-concept case-study aims to understand whether the engagement of individuals with dementia and Huntington's disease (HD) at an early stage is a useful approach to inform the initial development of meaningful digital activities and ultimately its potential introduction into clinical practice.Design/methodology/approachFive patients with dementia and HD at different stages of progression were recruited from an inpatient secure psychiatric hospital. Engagement, usability and preliminary benefits were assessed using a mixed-methods approach through observations, open-ended questions and subjective ratings.FindingsThe content of the tool triggered reminiscence, discussion and positive behavioural and emotional responses. The participants were confident using the tablet but needed support interacting with the touchscreen and, at times, to encourage communication. “Music” and “Videos”, were particularly successful in engaging most participants despite their cognitive and physical difficulties.Originality/valueThis case-study shows that co-production in clinical practice can be successfully implemented to develop activities that meet the interests and needs of patients with dementia and Huntington's disease. The varied and flexible assessment provided rich feedback that will be used to improve the device. This highlights avenues of focus for the development of future pools of activities.

AbstractIntrinsic capacity(IC) is a measure of physical, cognitive, vitality, psychological, and sensory abilities which determines functional ability. Decline in IC has been shown to accelerate the trajectory of frailty. We aim to show the impact of exercise (Ex) and cognitive stimulation therapy (CST) on (i) IC domains and composite score (ii) frailty and functional ability in pre-frail older adults. Secondary analysis of data from a pre-post intervention study of pre-frail older adults ≥ 65 years attending primary care clinic. Control (CON) and 2 intervention groups ((i) Ex 6 months (ii) CST 3 months with Ex 6 months (Ex+CST)) were recruited. Pre-frailty was determined using the FRAIL scale. Questionnaires (on demographics, functional ability, and depression) were administered and physical function assessment (gait speed (GS), short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted at 0, 3, 6 and 12 months. Four domains of IC were evaluated: locomotion (GS and 5x-STS), vitality (nutrition and muscle mass), cognition (MoCA and subjective cognitive decline) and psychological (depression and anxiety). Each domain was scored from 0 to 2 (no decline) with total IC score ranging from 0 to 8. 187 participants completed baseline and 3 months assessments, 109 (58.3%) were allocated to CON, 37 (19.8%) to Ex and 41 (21.9%) to Ex + CST groups. At 3 months, both Ex and Ex +CST showed improvement in IC composite scores, locomotion, and psychological domain scores but improvement in cognition domain only in Ex + CST group. At 6 months, there were improvements in total IC score, locomotion, vitality, and psychological domain in both Ex and Ex + CST groups. At 12 months, significant improvement was evident in total IC score for Ex and Ex+CST groups, vitality when fatigue (in addition to muscle mass and nutrition) was added and instrumental activities of daily living. Multidomain intervention incorporating exercise and CST resulted in significant improvement in IC composite scores, locomotion, vitality, cognition, and psychological domains.

Adopting a systematic approach to the development of an intervention, supported by robust theoretical, empirical, and clinical rationales represents best practice. The Medical Research Council (MRC) provides a framework for a systematic step-wise approach to the evaluation of complex interventions. This study describes the development phase of the individual cognitive stimulation therapy (iCST) for dementia trial, within this framework. In the preclinical phase, a recent Cochrane Review of cognitive stimulation for dementia and the current literature on individual cognitive stimulation interventions were examined to establish an evidence base. In addition, people with dementia, carers, and care staff were consulted regarding the acceptability of iCST, and a panel was put together to advise the team on the adaptation of group cognitive stimulation therapy (CST). Phase I (modeling) involved consultations with service users and experts in a series of focus groups, interviews, an online survey, and a consensus conference. Finally, Phase II field testing of the intervention was carried out. Two drafts of the materials were produced before a final version ready for use in the main randomized controlled trial (RCT). Key changes between the drafts included: editorial amendments to improve the clarity of instructions, emphasize the person centeredness of the approach, and reduce the overall length of the introduction section; the simplification of academic terminology and activities deemed \"too difficult\"; adjustments made to the monitoring-progress forms and session rating scale to enhance user-friendliness; the addition of a \"Getting started\" section; amendments made to the content of the toolkit; and clearer distinction made between the level of difficulty of activities. The rigorous development of the intervention was beneficial as the feasibility of the intervention was explored both in theory and practice, and consulting with service users ensured that materials were appropriately tailored to their needs. A Phase III RCT is currently being conducted to determine the effectiveness of iCST.

Purpose This paper aims to underline the importance of using a collaborative approach when designing and adapting a post diagnostic psychosocial intervention of cognitive stimulation therapy (CST) for people with intellectual disability and dementia. Design/methodology/approach As part of a service improvement, a manual of CST was adapted, for delivery in clinical practice. A qualitative co-production method allowed participants with a lived experience to provide regular feedback relating to the development of the adapted CST manual and intervention programme. This feedback was used to make continual development changes to the CST manual. Findings The study demonstrated co-production with those who provide care is valuable in adapting psychosocial therapies for people with an intellectual disability and dementia. Additional findings identified the need for carer education in ageing, dementia care and the physical health needs for older people with intellectual disability. Originality/value To the best of the authors’ knowledge, this is the first study that has used a co-production approach with families and carers in adapting a group therapy programme for people with an intellectual disability. This paper underlines the need for post diagnostic clinical interventions for people with dementia and those who provide care.

Purpose This paper describes the effectiveness of cognitive stimulation therapy (CST) on cognition and depressive symptoms in older adults in nursing homes (NHs). Design A randomized controlled trial, carried out from 2012 to 2013, included 56 residents from four NHs, 36 women and 20 men (randomized into experimental and control groups). Eight participants dropped out. Methods Participants of the experimental group underwent 14 CST sessions (7 weeks) in groups of six to eight older adults, and participants of the control group received usual care. The Montreal Cognitive Assessment, the Geriatric Depression Scale‐15, and the Barthel Index of activities of daily living (ADLs) were administered at baseline and postintervention. Findings Repeated measures revealed that CST increased cognition (F = 8.581; p = .005; partial η squared = 0.157; power = 0.82). There were no statistically significant differences in depressive symptoms (F = 1.090; p = .302). Baseline level of ADLs did not affect the outcomes. Conclusions CST had significantly improved cognition, explaining the 15.7% variability, but there was no statistical evidence of its effectiveness on depressive symptoms. This improvement was not affected by the baseline level of dependence‐independence in ADLs. Clinical Relevance CST offers a range of activities, providing general stimulation for thinking, concentration, and memory, usually in a social setting. These results will support implementation of CST in NHs. In addition to the impact on elderly independence and autonomy, CST may also have an economic impact by reducing the direct costs of the impact of elders’ cognitive frailty.

Background Cognitive Stimulation Therapy (CST) groups for people with dementia are available nationally, and internationally through voluntary organisations, memory services, and in residential care settings. However, groups may not be accessible or best suited for all. Individual Cognitive Stimulation Therapy (iCST) has been developed to provide another means of accessing CST. Methods The programme was field tested by 22 dyads (carers and people with dementia). Dyads were trained in the iCST approach and provided with a manual and accompanying resources. Researchers contacted dyads weekly to provide support and gather adherence data. Quantitative feedback about each session was also collected using ‘Monitoring Progress’ forms. Upon completion of their allocation sessions, researchers interviewed dyads about their experience. In total, nine dyads were followed up. Inductive thematic analysis was performed on the qualitative data. The aims of field testing were to assess the feasibility of the programme, and the appropriateness of the iCST materials. Results Sixty-two percent of the themes received an overall ‘high’ rating, and the majority of activities were classed as ‘low’ difficulty. Common barriers to completing sessions were; lack of time, illness, and motivation. Carers felt the manual and resources were ‘good’ and easy to use. Benefits of the programme for the person included; improvements in communication, mood, and alertness. The programme also gave carers insight into the person’s abilities and interests, and provided a new channel of communication. Little support was needed to deliver the programme. Conclusions Implementation of the iCST intervention was feasible. However, the majority of dyads completed fewer than three sessions per week. The training and support package appeared to be suitable as carers were able to deliver the intervention without intensive support. Barriers occurred largely as a result of life commitments, rather than problems with the intervention itself. This study was limited by a high loss to follow up rate. The effectiveness and cost effectiveness of iCST were investigated in a large scale randomised controlled trial (RCT). Trial registration ISRCTN65945963 Date of trial registration: 05/05/2010

Background Individual Cognitive Stimulation Therapy (iCST) is a one to one, carer led psychosocial intervention for people with dementia, adapted from group Cognitive Stimulation Therapy (CST). It is increasingly recognised that involving service users in research is key to developing interventions and treatments that successfully address their needs. This study describes the contribution of people with dementia and carers during the development phase of the intervention and materials. Methods Twenty-eight people with dementia and 24 carers were consulted in a series of six focus groups and 10 interviews. The purpose of this study was to gain insight into perceptions of mental stimulation from the point of view of carers and people with dementia, to ensure the materials are easy to use, clear, and appropriately tailored to the needs of people with dementia and their carers, and to assess the feasibility of the intervention. Results The importance of mental stimulation was emphasized by carers and people with dementia. People with dementia saw activities as a way of ‘keeping up to date’ and spending time in a meaningful way. Carers reported benefits such as improved quality of life, mood and memory. The concept of iCST was well received, and both carers and people with dementia responded positively to the first drafts of materials. Feasibility issues, such as finding time to do sessions, were identified. Conclusion The feedback from the focus groups and interviews will be used to further develop and refine the iCST programme materials in preparation for a field testing phase prior to a large scale randomized controlled trial (RCT). Trial registration ISRCTN65945963 . Date of registration: 05/05/2010.