Aguirre, E; (2012) The development and evaluation of a Maintenance Cognitive Stimulation Therapy (CST) programme for people with dementia. Doctoral thesis , UCL (University College London).

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Abstract

Background: Cognitive Stimulation Therapy (CST) is a cognitiveDbased approach for dementia that has been shown to be cost effective and beneficial for cognition and quality of life. However future evidence is needed in relation to the length of the programme required and the effects of CST over an extended period. Aim: To develop and evaluate a 24Dweek programme of MCST, following the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Methods: A Cochrane Review was conducted in order to consolidate the evidence of cognitive stimulation for dementia and the results were used in the development of the programme, including a Delphi process with a consensus conference and focus groups with service users. A multicentre randomised controlled trial followed, including 18 centres and recruiting 272 people with mild to moderate dementia who received CST initially and were randomised afterwards to receive 24 weeks of either MCST or treatment as usual. Results: The intention to treat analysis showed that the MCST programme significantly improved quality of life of people with dementia at three and six months follow up, and activities of daily living at three month follow up. A sub analysis of people on acetyl cholinesterase inhibitors, showed that the effects of the longDterm intervention were additive to the medication effect. Conclusion: This study provides good evidence for the longDterm quality of life benefits of the CST maintenance programme for people with dementia.

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