Cognitive Stimulation Therapy (CST) for older adults with mild-to-moderate dementia in Italy: effects on cognitive functioning, and on emotional and neuropsychiatric symptoms

Objectives: Cognitive Stimulation Therapy (CST) is one of the most popular evidence-based interventions for people with dementia. The aim of the present study was to assess the effectiveness in the short and long term (on completing the treatment and 3 months later) of an Italian adaptation of the CST protocol (CST-IT). Method: Older adults with mild-to-moderate dementia at 16 residential care homes were randomly assigned to a CST-IT group (N=123), or an active control group (N=102). The following domains were examined for potential benefits: general cognitive functioning (Mini-Mental State Examination [MMSE] and the Alzheimer’s Disease Assessment Scale - Cognitive subscale [ADAS-Cog]), and language (Narrative Language Test); mood and behavior (Cornell scale and Neuropsychiatric Inventory); everyday life functioning (Disability Assessment for Dementia), and quality of life (Quality of Life - Alzheimer’s Disease scale). Results: At both the short- and long-term assessments, the CST-IT group’s MMSE scores remained stable, while the control group’s scores decreased slightly from pre-test to post-test and follow-up. The CST-IT group also had short-term benefits in other cognitive measures (ADAS-Cog and Narrative Language Test), and mood and behavior measures, which were generally maintained at follow-up. No other differences were observed. Discussion: The effectiveness of CST in sustaining cognitive and emotional functioning, and counteracting the progression of behavioral/neuropsychiatric symptoms in people with dementia was confirmed, and a long-term benefit was demonstrated. CST is a promising option for the treatment of people with dementia in clinical practice.