EC Neurology

Background and Aim: Pharmacological treatments for dementia can be limited in terms of availability, eligibility and costs. This has led us to more recent development and use of non-pharmacological interventions. Cognitive Stimulation Therapy (CST) [1] is a group treatment for mild to moderate dementia, with global efficacy in cognition and quality of life. This study aimed to culturally adapt and evaluate CST in an Argentinian context.

Methods: Prospective pre-and post-treatment study design. Forty-one patients with mild cognitive impairment (MCI) and mild dementia were included. Results were compared with a cohort of 81 patients receiving care at the Memory Clinic, serving as a non-intervention control group. All participants were evaluated a minimum of twice, at the diagnostic consultation and at one-year follow-up. Cognitive performance was assessed using the following tests: the Mini-Mental State Examination (MMSE) by Folstein., et al. the Addenbrooke's Cognitive Examination-Revised (ACE-R), and the Frontal Assessment Battery (FAB). Quality of life was assessed using the Quality of Life in Alzheimer's Disease scale (QoL-AD) [2].

Results and Conclusion: The results demonstrated that the treatment group achieved significantly higher scores on the MMSE (p = .002) and the ACE-R (p = .005) compared to the control group, which exhibited a significant decline in performance. The group receiving treatment also showed a positive and statistically significant impact on quality of life. These findings indicate that groups who received CST improved in both cognitive function and quality of life. Based on our experience, participants expressed a desire to continue with Cognitive Stimulation Therapy after completing the 14-session program. Consequently, future studies will explore the implementation of a maintenance therapy phase.

Keywords: Cognitive Stimulation Therapy; Efficacy; Mild Cognitive Impairment; Dementia; Cultural Adaptation

1. Spector A., et al. “Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial”. British Journal of Psychiatry 3 (2003): 248-254.
2. Logsdon RG., et al. “Quality of life in Alzheimer's disease: patient and caregiver reports”. Journal of Mental Health and Aging1 (1999): 21-32.
3. Nitrini R., et al. “Prevalence of dementia in Latin America: a collaborative study of population-based cohorts”. International Psychogeriatrics 4 (2009): 622-630.
4. Prince M., et al. “Dementia diagnosis in developing countries: a cross-cultural validation study”. Lancet 9361 (2003): 909-917.
5. Guía oficial de práctica clínica en demencias. 2018, Sociedad Española de Neurología. Depósito Legal: M-36109 (2018): 58.
6. Miranda-Castillo C., et al. “Implementación de un programa de estimulación cognitiva en personas con demencia tipo Alzheimer: un estudio piloto en chilenos de la tercera edad”. Universitas Psychologica2 (2013): 445-455.
7. Stern Y., et al. "Whitepaper: Defining and investigating cognitive reserve, brain reserve, and brain maintenance". Alzheimer's and Dementia: The Journal of the Alzheimer's Association 9 (2019): 1305-1311.
8. McDermott O., et al. “Psychosocial interventions for people with dementia: A synthesis of systematic reviews”. Aging and Mental Health4 (2019): 393-403.
9. Spector A., et al. “Cognitive Stimulation Therapy (CST): Effects on different areas of cognitive function for people with dementia”. International Journal of Geriatric Psychiatry 12 (2010): 1253-1258.
10. Yates Lauren A., et al. “Cognitive stimulation therapy for dementia: history, evolution and internationalism”. Routledge (2017).
11. Clare L and Woods RT. “Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer’s disease: A review”. Neuropsychological Rehabilitation 14 (2004): 385-401.
12. National Institute for Health and Clinical Excellence (NICE) and Social Care Institute for Excellence (SCIE). “Dementia: A NICE-SCIE Guideline on supporting people with dementia and their carers in health and social care”. NICE Clinical Guideline 42. London: National Institute for Health and Clinical Excellence (2007).
13. Desai Roopal., et al. "Effectiveness of cognitive stimulation therapy (CST) for mild to moderate dementia: a systematic literature review and meta-analysis of randomised control trials using the original CST protocol". Ageing Research Reviews 97 (2024): 102312.
14. Knapp M., et al. “What are the current and projected future cost and health‐related quality of life implications of scaling up cognitive stimulation therapy?” International Journal of Geriatric Psychiatry1 (2022).
15. Medel N., et al. “Adaptación cultural de una terapia de estimulación cognitive”. Vertex Revista Argentina De Psiquiatría166 (2025): 47-55.
16. Kochen S., et al. “Screening of cognitive impairment: undiagnosed or over diagnosis in a vulnerable population”. Journal of Neuroscience and Cognitive Studies 1 (2018): 1009.
17. González-Salvador T., et al. “Quality of life in dementia patients in long-term care”. International Journal of Geriatric Psychiatry 2 (2000): 181-189.
18. Woods RT. “Reality orientation and staff Reality orientation and staff attention: a controlled study. attention: a controlled study”. British Journal of Psychiatry 134 (1979): 502-507.
19. Breuil V., et al. “Cognitive stimulation of patients with dementia: Cognitive stimulation of patients with dementia: preliminary results”. International Journal of Geriatric Psychiatry3 (1994): 211-217.
20. Spector A., et al. “Can reality orientation be rehabilitated? Development and piloting of an evidence-based programme of cognition-based therapies for people with dementia”. Neuropsychological Rehabilitation3-4 (2001): 377-397.
21. Knopman DS and Petersen RC. “Mild cognitive impairment and mild dementia: A clinical perspective”. Mayo Clinic Proceedings10 (2014): 1452-1459.