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Cited by 34Dementia and Cognitive Impairment ResearchParkinson's Disease Mechanisms and TreatmentsNursing care and research

Parkinson’s-adapted cognitive stimulation therapy: a pilot randomized controlled clinical trial

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Leroi, Iracema, Vatter, Sabina, Carter, Lesley-Anne, Smith, Sarah J., Orgeta, Vasiliki, Poliakoff, Ellen, Silverdale, Monty A., Raw, Jason +5 more·2019·Therapeutic Advances in Neurological Disorders
DOI 10.1177/1756286419852217PMC PMC6611028
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Abstract

Cognitive stimulation therapy (CST) is widely used with people with dementia, but there is no evidence of its efficacy in mild cognitive impairment or dementia in Parkinson’s disease (PD-MCI; PDD) or dementia with Lewy bodies (DLB). We aimed to explore the impact of ‘CST-PD’, which is home-based, individualized CST adapted for this population. In a single-blind, randomized controlled exploratory pilot trial (RCT), we randomized 76 participant–dyads [PD-MCI ( n = 15), PDD ( n = 40), DLB ( n = 21) and their care partners] to CST-PD or treatment as usual (TAU). CST-PD involves home-based cognitively stimulating and engaging activities delivered by a trained care partner. Exploratory outcomes at 12 weeks included cognition (Addenbrooke’s Cognitive Evaluation; ACE-III), neuropsychiatric symptoms and function. In care partners, we assessed burden, stress and general health status. Relationship quality and quality of life were assessed in both dyad members. At 12 weeks, the ACE-III showed a nonstatistically significant improvement in the CST-PD group compared with the TAU group, although neuropsychiatric symptoms increased significantly in the former. In contrast, care partners’ quality of life ( d = 0.16) and relationship quality (‘satisfaction’, d = 0.01; ‘positive interaction’, d = 0.55) improved significantly in the CST-PD group, and care burden ( d = 0.16) and stress ( d = 0.05) were significantly lower. Qualitative findings in the CST-PD recipients revealed positive ‘in the moment’ responses to the intervention, supporting the quantitative results. In conclusion, care-partner-delivered CST-PD may improve a range of care-partner outcomes that are important in supporting home-based care. A full-scale follow-up RCT to evaluate clinical and cost effectiveness is warranted.

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Research works printed but not linked: 49

  1. [1]McKeith IG Burn D. Spectrum of Parkinson’s disease, Parkinson’s dementia, and Lewy body dementia. Neurol Clin 2000; 18: 865– 883. 11072265
  2. [2]Aarsland D Bronnick K Williams-Gray C et al Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 2010; 75: 1062– 1069. 20855849 PMC2942065
  3. [3]Hely MA Reid WGJ Adena MA et al The Sydney Multicenter Study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord 2008; 23: 837– 844. 18307261
  4. [4]Leroi I McDonald K Pantula H et al Cognitive impairment in parkinson disease: impact on quality of life, disability, and caregiver burden. J Geriatr Psychiatry Neurol 2012; 25: 208– 214. 23172765
  5. [5]Sindhi A Leroi I. Nonpharmacological therapies for cognitive enhancement in Parkinson’s disease: applying old interventions in a new setting? Neurodegener Dis Manag 2013; 3: 1– 9.
  6. [6]Hindle JV Watermeyer TJ Roberts J et al Goal-orientated cognitive rehabilitation for dementias associated with Parkinson’s disease-a pilot randomised controlled trial. Int J Geriatr Psychiatry 2018; 33: 718– 728. 29314218
  7. [7]Spector A Thorgrimsen L Woods B et al Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. Br J Psychiatry 2003; 183: 248– 254. 12948999
  8. [8]Orrell M Yates L Leung P et al The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: a randomised controlled trial. PLoS Med 2017; 1– 22. PMC5369684 28350796
  9. [9]Woods B Aguirre E Spector AE et al Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012; 2: CD005562. 22336813
  10. [10]Huntley JD Gould RL Liu K et al Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ Open 2015; 5: e005247. PMC4390716 25838501
  11. [11]Folkerts AK Dorn ME Roheger M et al Cognitive stimulation for individuals with Parkinson’s disease dementia living in long-term care: preliminary data from a randomized crossover pilot study. Parkinsons Dis 2018; 8104673. 30631420 PMC6304852
  12. [12]McCormick SA McDonald KR Vatter S et al Psychosocial therapy for Parkinson’s-related dementia: intervention development. Clin Interv Aging 2017; 12. PMC5659232 29118576
  13. [13]McCormick SA Vatter S Carter L-A et al Feasibility and acceptability of a psychosocial therapy for Lewy body spectrum disorders: the INVEST Study. J Neurol 2019. PMC6586694 31161388
  14. [14]McCormick SA McDonald KR Vatter S et al Psychosocial therapy for Parkinson’s-related dementia: study protocol for the INVEST randomised controlled trial. BMJ Open 2017; 7: e016801. doi:10.1136/bmjopen-2017-016801. PMC5726123 28630086 · DOI
  15. [15]Litvan I Goldman JG Tröster AI et al Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 2012; 27: 349– 356. 22275317 PMC3641655
  16. [16]Emre M Aarsland D Brown R et al Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 2007; 22: 1689– 1707. 17542011
  17. [17]McKeith IG Boeve BF Dickson DW et al Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology 2017; 89: 88– 100. 28592453 PMC5496518
  18. [18]Nasreddine Z Phillips N Bédirian V et al The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695– 699. 15817019
  19. [19]Hsieh S Schubert S Hoon C et al Validation of the Addenbrooke’s cognitive examination III in frontotemporal dementia and Alzheimer’s Disease. Dement Geriatr Cogn Disord 2013; 36: 242– 250. 23949210
  20. [20]Lee DR McKeith I Mosimann U et al The dementia cognitive fluctuation scale, a new psychometric test for clinicians to identify cognitive fluctuations in people with dementia. Am J Geriatr Psychiatry 2014; 22: 926– 935. 24332982
  21. [21]Reginold W Armstrong MJ Duff-Canning S et al The pill questionnaire in a nondemented Parkinson’s disease population. Mov Disord 2012; 27: 1308– 1311. 22865587
  22. [23]EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199– 208. 10109801
  23. [24]Cummings JL Mega M Gray K et al The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308– 2314. 7991117
  24. [25]Zigmond AS Snaith PR. The hospital anxiety and depression scale. 1983; 67: 361– 370. 6880820
  25. [26]Sockeel P Dujardin K Devos D et al The Lille apathy rating scale (LARS), a new instrument for detecting and quantifying apathy: validation in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006; 77: 579– 584. 16614016 PMC2117430
  26. [27]Ware JE Jr Kosinski M Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996; 34: 220– 233. 8628042
  27. [29]Sebern MD Whitlatch CJ. Dyadic relationship scale: a measure of the impact of the provision and receipt of family care. Gerontologist 2007; 47: 741– 751. 18192628
  28. [30]Schofield HL Murphy B Herrman HE et al Family caregiving: measurement of emotional well-being and various aspects of the caregiving role. Psychol Med 1997; 27: 647– 657. 9153685
  29. [31]Zarit SH Reever KE Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980; 20: 649– 655. 7203086
  30. [32]Greene JG Smith R Gardiner M et al Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age Ageing 1982; 11: 121– 126. 7102472
  31. [34]Davis MH. A multidimensional approach to individual differences in empathy. J Pers Soc Psychol 1983; 44: 113– 126.
  32. [35]Onder G Zanetti O Giacobini E et al Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomised controlled trial. Br J Psychiatry 2005; 187: 450– 455. 16260821
  33. [37]Arain M Campbell MJ Cooper CL et al What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol 2010; 10: 1– 7. 20637084 PMC2912920
  34. [40]Winter L Gitlin LN Dennis M. Desire to institutionalize a relative with dementia: quality of premorbid relationship and caregiver gender. Fam Relat 2011; 60: 221– 230.
  35. [41]Spruytte N Van Audenhove C Lammertyn F et al The quality of the caregiving relationship in informal care for older adults with dementia and chronic psychiatric patients. Psychology and Psychotherapy 2002; 75: 295– 311. 12396755
  36. [42]Woods B Aguirre E Spector A et al Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012; CD005562. 22336813
  37. [43]Spector A Orrell M Woods B. Cognitive stimulation therapy (CST): effects on different areas of cognitive function for people with dementia. Int J Geriatr Psychiatry 2010; 25: 1253– 1258. 20069533
  38. [44]Daniele A Panza F. Can a cognitive rehabilitation program in early stages of Parkinson’s disease improve cognition, apathy and brain functional connectivity for up to 18 months? Eur J Neurol 2018; 25: 203– 204. 29215769
  39. [45]Diez-Cirarda M Ojeda N Peña J et al Long-term effects of cognitive rehabilitation on brain, functional outcome, and cognition in Parkinson’s disease. Eur J Neurol 2018; 25: 5– 12. 28940855 PMC5765471
  40. [46]Cove J Jacobi N Donovan H et al Effectiveness of weekly cognitive stimulation therapy for people with dementia and the additional impact of enhancing cognitive stimulation therapy with a carer training program. Clin Interv Aging 2014; 9: 2143– 2150. 25525349 PMC4267515
  41. [47]Vatter S McDonald KR Stanmore E et al Multidimensional care burden in Parkinson’s-related dementia. J Geriatr Psychiatry Neurol 2018; 31: 319– 328. 30244631
  42. [48]Vatter S McDonald KR Stanmore E et al A qualitative study of female caregiving spouses’ experiences of intimate relationships as cognition declines in Parkinson’s disease. Age Ageing 2018; 47: 604– 610. 29617933 PMC6014155
  43. [49]Martínez-Martín P Benito-León J Alonso F et al Quality of life of caregivers in Parkinson’s disease. Qual Life Res 2005; 14: 463– 472. 15892435
  44. [50]O’Connor EJ McCabe MP. Predictors of quality of life in carers for people with a progressive neurological illness: a longitudinal study. Qual Life Res 2011; 20: 703– 711. 21127997
  45. [51]Holicky R. Caring for the caregivers: the hidden victims of illness and disability. Rehabil Nurs 1996; 21: 247– 252. 8868755
  46. [52]Clare L Nelis SM Whitaker CJ et al Marital relationship quality in early-stage dementia: perspectives from people with dementia and their spouses. Alzheimer Dis Assoc Disord 2012; 26: 148– 158. 21685780
  47. [53]Spruytte N Van Audenhove C Lammertyn F. Predictors of institutionalization of cognitively-impaired elderly cared for by their relatives. Int J Geriatr Psychiatry 2001; 16: 1119– 1128. 11748770
  48. [55]Steadman PL Tremont G Duncan Davis J. Premorbid relationship satisfaction and caregiver burden in dementia caregivers. J Geriatr Psychiatry Neurol 2007; 20: 115– 119. 17548782 PMC1890033
  49. [57]Mueller C Ballard C Corbett A et al The prognosis of dementia with Lewy bodies. Lancet Neurol 2017; 16: 390– 398. 28342649

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Authors
Leroi, I., Vatter, S., Carter, L.-A., Smith, S. J., Orgeta, V., Poliakoff, E., Silverdale, M. A., Raw, J., Ahearn, D. J., Taylor, C., Rodda, J., Abdel-Ghany, T., & McCormick, S. A.
Affiliations
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
  • University of Manchester (GB)
  • Leeds Beckett University (GB)
  • University College London (GB)
  • Salford Royal NHS Foundation Trust (GB)
  • Pennine Acute Hospitals NHS Trust (GB)
  • Manchester University NHS Foundation Trust (GB)
  • Derbyshire Healthcare NHS Foundation Trust, Kingsway, UK
  • North East London NHS Foundation Trust (GB)
  • North West Boroughs Healthcare NHS Foundation Trust (GB)
Corresponding author
Leroi, Iracema
ORCID
Venue
Therapeutic Advances in Neurological Disorders
Publisher
SAGE Publications
Published
2019-01
Volume
12
Pages
1756286419852217-1756286419852217
ISSN
  • 1756-2856 (ISSN-L)
  • 1756-2864
DOI
10.1177/1756286419852217
PMC
PMC6611028
OpenAlex
W2944052685
Cited by
34
References
7
Citations by year
2026: 1 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 1 · 2020: 5 · 2019: 1 · 2018: 1
FWCI
2.59
Type
journal article
Language
en
Open access
Licence
Locations
  • Therapeutic Advances in Neurological Disorders (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, cc-by-nc)
  • Leeds Beckett Repository (Leeds Beckett University) (acceptedVersion)
  • UCL Discovery (University College London) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute for Health Research (NIHR) Research for Patient Benefit (RfPB) Programme (PB-PG-0613-31058)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
Keywords
cognitive stimulation therapy, Parkinson's disease, dementia with Lewy bodies, mild cognitive impairment, home-based intervention, care partners, caregiver burden, neuropsychiatric symptoms, relationship quality, quality of life, dyadic intervention

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