Social engagement may be as important as cognitive stimulation therapy in dementia

Orrell and colleagues confirm that group and individual cognitive stimulation therapy (CST) improves cognitive function in dementia but that the effect size is modest, and they do not mention the possibly large placebo effect of social engagement. 1 In their own trial of group CST, they state that controls received usual activities, which generally meant inactivity. 2 The principles of CST entail a focused process in the context of supportive relationships (with fellow participants and the facilitator), an expectation of helpfulness, and the prospect of an enjoyable experience. Wellbeing in later life is associated with strong community affiliation, a sense of purpose, and the opportunity to contribute to the lives of others, 3 all of which are fostered by group CST. [...]the efficacy of group CST over individual CST probably results from the convergence of these associations.