Cognitive stimulation and activities of daily living for individuals with mild-to-moderate dementia: A scoping review.
Simone Ryan, Orla Brady
PMID 40337614WHAT IT FOUND
Cognitive stimulation did not consistently improve daily activities in mild-to-moderate dementia.
Standard group programmes mostly showed no ADL benefit. Multi-component programmes that trained daily tasks looked more promising, but were intensive and often residential.
Key findings
01Across 36 studies, evidence for cognitive stimulation improving daily activities was mixed, with most standard CST and group CS programmes showing no significant ADL benefit.
02Some multi-component programmes that combined CS with ADL training or motor activities showed ADL improvements, although gains were not always maintained.
03The more favourable multi-component results came from intensive programmes often tested in residential or day-care settings, so they may not transfer to community practice.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a scoping review, not a trial, and it did not formally assess the quality or risk of bias of included studies. The review protocol was not registered or published, which limits reproducibility. Searches were limited to English-language, full-text articles, and some full texts were unavailable. Studies with dual diagnoses were excluded, and some included studies had participants with mild cognitive impairment or severe dementia. ADL outcomes were often secondary and may not have been measured with sensitive tools. Many positive multi-component programmes were intensive and conducted in residential or day-care settings, so they may not be feasible in community practice. Some positive findings came from small pilot studies, case reports or case series, which cannot prove effectiveness.
The easy way to misread this
Do not conclude that cognitive stimulation reliably improves daily activities in mild-to-moderate dementia. Most standard CST and group CS studies showed no ADL benefit, and the more promising multi-component programmes were intensive and often tested in residential care.