Evaluation of an Occupational Therapy led Cognitive Stimulation Therapy Programme in an Integrated Care Programme for Older Persons

Abstract Background Cognitive Stimulation Therapy (CST) is a non-pharmacological, evidence-based approach specifically designed to support people with dementia to maintain their cognitive functions e.g. reminiscence, higher executive skills, sensory integration, orientation, memory strategies and day-to-day activities. Methods Participants referred to a community specialist ICPOP team were identified for CST following Comprehensive Geriatric Assessment (CGA), where cognitive impairment or dementia was identified. Inclusion criteria: Rockwood Clinical Frailty Scale ≤5, Barthel Index of Activities of Daily Living ≥11, Lawton Brody Instrumental Activities of Daily Living Scale (IADL) ≥4, Montreal Cognitive Assessment (MoCA) ≥10, and ability to consent to participate. Addenbrooks Cognitive Examination (ACE-III) scores were obtained pre and post CST, alongside post CST feedback questionnaires. Results 5 CST programmes of seven weeks duration were conducted over a ten-month period. 31 (male=16, female=15) participants completed the programme. 3 participants dropped out due to lack of transport/interest. The average ACE-III score pre-CST was 68.3 +/- 14.31; post-CST was 76.1 +/- 11.4. 28 participants completed feedback questionnaires. Positive feedback included “Got a great sense of achievement with each session, and eagerly looked forward to the coming weeks”, “Each session topped the previous session” “Gave me a reason to get out, a routine to my week”. 45 % commented that they felt safe sharing difficulties/problems with the group. 71% reflected that CST provided an opportunity to meet others in a similar situation. 100% would recommend CST to others. Conclusion Experience of CST was overwhelmingly positive demonstrating benefit not only from a cognitive perspective but from informal peer support and connections made in group settings. Participants commented on lack of follow-on programmes, identifying the need to develop maintenance CST programmes led by trained community stakeholders which would sustain these benefits long-term as well as increasing awareness and knowledge of dementia within communities.