Cited by 855Dementia and Cognitive Impairment ResearchCognitive Functions and MemoryGeriatric Care and Nursing Homes

The DOI matches its Crossref record; 148 of the 148 references it cites were found in a registry or an index.

Cognitive stimulation to improve cognitive functioning in people with dementia

Open access
Woods, Bob, Aguirre, Elisa, Spector, Aimee E, Orrell, Martin·2012·Cochrane Database of Systematic Reviews

Abstract

BACKGROUND: Cognitive stimulation is an intervention for people with dementia which offers a range of enjoyable activities providing general stimulation for thinking, concentration and memory usually in a social setting, such as a small group. Its roots can be traced back to Reality Orientation (RO), which was developed in the late 1950s as a response to confusion and disorientation in older patients in hospital units in the USA. RO emphasised the engagement of nursing assistants in a hopeful, therapeutic process but became associated with a rigid, confrontational approach to people with dementia, leading to its use becoming less and less common.Cognitive stimulation is often discussed in normal ageing as well as in dementia. This reflects a general view that lack of cognitive activity hastens cognitive decline. With people with dementia, cognitive stimulation attempts to make use of the positive aspects of RO whilst ensuring that the stimulation is implemented in a sensitive, respectful and person-centred manner.There is often little consistency in the application and availability of psychological therapies in dementia services, so a systematic review of the available evidence regarding cognitive stimulation is important in order to identify its effectiveness and to place practice recommendations on a sound evidence base. OBJECTIVES: To evaluate the effectiveness and impact of cognitive stimulation interventions aimed at improving cognition for people with dementia, including any negative effects. SEARCH METHODS: The trials were identified from a search of the Cochrane Dementia and Cognitive Improvement Group Specialized Register, called ALOIS (updated 6 December 2011). The search terms used were: cognitive stimulation, reality orientation, memory therapy, memory groups, memory support, memory stimulation, global stimulation, cognitive psychostimulation. Supplementary searches were performed in a number of major healthcare databases and trial registers to ensure that the search was up to date and comprehensive. SELECTION CRITERIA: All randomised controlled trials (RCTs) of cognitive stimulation for dementia which incorporated a measure of cognitive change were included. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two review authors using a previously tested data extraction form. Study authors were contacted for data not provided in the papers. Two review authors conducted independent assessments of the risk of bias in included studies. MAIN RESULTS: Fifteen RCTs were included in the review. Six of these had been included in the previous review of RO. The studies included participants from a variety of settings, interventions that were of varying duration and intensity, and were from several different countries. The quality of the studies was generally low by current standards but most had taken steps to ensure assessors were blind to treatment allocation. Data were entered in the meta-analyses for 718 participants (407 receiving cognitive stimulation, 311 in control groups). The primary analysis was on changes that were evident immediately at the end of the treatment period. A few studies provided data allowing evaluation of whether any effects were subsequently maintained. A clear, consistent benefit on cognitive function was associated with cognitive stimulation (standardised mean difference (SMD) 0.41, 95% CI 0.25 to 0.57). This remained evident at follow-up one to three months after the end of treatment. In secondary analyses with smaller total sample sizes, benefits were also noted on self-reported quality of life and well-being (standardised mean difference: 0.38 [95% CI: 0.11, 0.65]); and on staff ratings of communication and social interaction (SMD 0.44, 95% CI 0.17 to 0.71). No differences in relation to mood (self-report or staff-rated), activities of daily living, general behavioural function or problem behaviour were noted. In the few studies reporting family caregiver outcomes, no differences were noted. Importantly, there was no indication of increased strain on family caregivers in the one study where they were trained to deliver the intervention. AUTHORS' CONCLUSIONS: There was consistent evidence from multiple trials that cognitive stimulation programmes benefit cognition in people with mild to moderate dementia over and above any medication effects. However, the trials were of variable quality with small sample sizes and only limited details of the randomisation method were apparent in a number of the trials. Other outcomes need more exploration but improvements in self-reported quality of life and well-being were promising. Further research should look into the potential benefits of longer term cognitive stimulation programmes and their clinical significance.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd005562.pub2

Cites

148 of 148 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

1 retracted

Flagged first, then by citations

Research works printed but not linked: 14

  1. Ferrario, 1991, Reality orientation therapy in institutionalized elderly patients: Preliminary results, Archives of Gerontology and Geriatrics, 12 Suppl 2, 139
  2. Croisile, 2006, Memory stimulation. What rational? What exercises?, Revue de Geriatrie, 31, 421
  3. Faggian, 2007, An intervention protocol on cognitive abilities for subjects with severe cognitive impairment, Giornale di Gerontologia, 55, 134
  4. Hernandez, 2007, Effects of combined pharmacologic and cognitive treatment in the progression of moderate dementia: A two-year follow-up, Revista Espanola de Geriatria y Gerontologia, 42, 3
  5. Ruiz Sanchez De Leon, 2007, Computer-based cognitive training and donepezil: Combined therapy effects in cognitive impairment, Mapfre Medicina, 18, 25
  6. Schreiber, 1998, Development and evaluation of an interactive computer-based training as a rehabilitation tool for dementia, Psychologie Beitrage, 40, 85
  7. Tarraga L Randomised pilot study to evaluate the efficacy of an interactive multimedia system for the cognitive stimulation of Alzheimer's disease patients 1st International Consensus Conference Non pharmacological Therapies for Alzheimer's, Madrid, May 12-13 2005 35 6
  8. Tarraga, 2007, Interactive cognitive stimulation with a computer and Alzheimer's disease, Neuroscientist, 13, 97
  9. Wenish, 2005, A global intervention program for institutionalized demented patients, Revue Neurologique, 161, 290
  10. Zanetti, 2004, Effectiveness of the association of donepezil and Reality Orientation Therapy, Giornale di Gerontologia, 52, 480
  11. Zientz, 2007, Evidence-based practice recommendations: Caregiver-administered active cognitive stimulation for individuals with Alzheimer's disease., Journal of Medical Speech-Language Pathology, 15, 27
  12. Fernandez-Calvo, 2010, The effect of an individual or group intervention format in cognitive stimulation of patients with Alzheimer's disease., Revista de Psicopatología y Psicología Clínica, 15, 115
  13. Mohs, 2000, Neuropsychological assessment of patients with Alzheimer's disease, http://www.acnp
  14. NICE-SCIE, 2006, Dementia: Supporting people with dementia and their carers in health and social care: Clinical Guideline 42.

Cited by

Sorted by citations

Metadata

Authors
Woods, B., Aguirre, E., Spector, A. E., & Orrell, M.
Affiliations
  • Bangor University (GB)
  • University College London (GB)
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2012-02-15
Issue
2
Pages
CD005562-CD005562
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
OpenAlex
W1529409337
Cited by
855
References
148
Citations by year
2026: 16 · 2025: 61 · 2024: 62 · 2023: 58 · 2022: 63 · 2021: 66 · 2020: 79 · 2019: 64 · 2018: 58 · 2017: 74 · 2016: 70 · 2015: 51 · 2014: 54 · 2013: 46 · 2012: 29
FWCI
7.78
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
National Institute for Health and Care Research (RP-PG-0606-1083)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
  • Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
Keywords
cognitive stimulation, dementia, cognitive function, reality orientation, memory stimulation, memory therapy, group activities, person-centred care, cognitive decline, intervention effectiveness, risk of bias, older adults, nursing homes, community-dwelling older adults, dementia services, normal aging
MeSH terms
Aged, Cognition, Dementia, Humans, Memory, Orientation, Psychotherapy, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review