Cognitive Stimulation for People with Dementia in Long-Term Care Facilities: Baseline Cognitive Level Predicts Cognitive Gains, Moderated by Depression
Affiliations: [a] Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta, Germany | [b] Department of Medical Psychology/Neuropsychology and Gender Studies (CeNDI), University Hospital Cologne, Cologne, Germany
Correspondence:
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Correspondence to: Elke Kalbe, PhD, Department of Medical Psychology/Neuropsychology and Gender Studies (CeNDI), University Hospital Cologne, Kerpener Str. 68, 50937 Köln, Germany. Tel.: +49 221 478 6669; Fax: +49 221 478 3420; E-mail: [email protected].
Abstract: Background: Increasing evidence demonstrates the efficacy of cognitive stimulation (CS) in individuals with dementia. However, conducting studies in nursing homes engenders specific challenges that have limited the data gathered on this topic so far. Objective: The aim of this randomized controlled trial was to investigate the effects of CS on cognition, quality of life (QoL), behavioral symptoms, and activities of daily life in persons with dementia living in nursing homes. We further aimed to identify predictors of the intervention’s benefits. Methods: Seventy-one persons with mild to moderate dementia were randomly allocated to the experimental group (EG; n = 36) that visited a CS program twice weekly for eight weeks or to the control group (CG; n = 35) that was receiving usual care. Neuropsychological tests were conducted before and after the intervention period and at six-week follow-up. Results: There were no significant interaction effects Time×Group for the outcome measures. However, regression analysis revealed that a low cognitive baseline level predicted cognitive improvements. Furthermore, a low baseline level of QoL predicted a QoL benefit. For both findings, depression was a significant moderator, meaning that persons with fewer depressive symptoms had a higher probability of showing improvements. Conclusion: This study provides data on profiles of patients who are most likely to profit from CS intervention in nursing-home settings and demonstrates that treatment of depression is of the utmost relevance for a positive outcome of CS. Living conditions will have to be considered more thoroughly in future research.
Keywords: Cognitive stimulation, dementia, depression, intervention, nursing homes, quality of life
