About iCST Intervention

What is the iCST Intervention? 

The iCST study is a Health and Technology Assessment funded programme (HTA), sponsored by University College London (UCL).

It aims to increase quality of life and cognition for people with dementia.

In response to the government's emphasis on improving early interventions and home care for people with dementia, we developed a home-based individual Cognition Stimulation Therapy (CST) package delivered by family carers.
 

What is the iCST Therapy?

Individual Cognitive Stimulation Therapy (iCST) is based on the evidence-based group CST therapy for people with mild to moderate dementia, which has been found to be beneficial for cognition and quality of life.

The individual CST programme is delivered by a relative or close friend of the person with dementia for:

• 30 minutes 
• 3 times a week
• over 25 weeks

Each individual CST session consists of a themed activity (i.e. life story, discussion of current affairs, being creative) and is designed to be mentally stimulating.

What did the research do?

356 pairs of people with dementia and carers were recruited to a multi-centre randomised controlled trial (RCT).

The research team produced the iCST programme (including a manual, activity workbook, and materials such as maps and dominoes) in collaboration with people with dementia, carers, health care professionals, and experts.

What did the researchers find?

The quantitative results

People with dementia receiving iCST reported better relationship quality with their family carer. It was measured by Quality Caregiver/Patient Relationship for person with dementia. Carers delivering iCST had better quality of life at 26 weeks. Carers who completed more sessions had fewer depressive symptoms.

However, people with dementia receiving iCST did not benefit cognition or QOL It might be associated with a low adherence to the intervention during the trial.

The qualitative findings

The overall experience of participating in iCST was described as having opportunities to engage in enjoyable mentally stimulating activities, motivation to stay active and bringing people with dementia and their carers ‘together’. It also provided opportunities to communicate.

Family carers mentioned that finding time to do the sessions and their relatives being reluctant to engage in the activities could hinder their participation in the intervention.

What do the iCST finding mean?

Taking part in the iCST intervention motivated people with dementia to keep their mind active and look for more information related to mental stimulation. Enhancing the caregiving relationship quality and improving carers well-being through iCST are the important and meaningful outcomes for people with dementia and their carers.

iCST could be a useful tool for carers and people with dementia. It provides an opportunity for dyads to spend quality time together and is an aid to communication and enhancing carer health related QoL and mood.

Both people with dementia and family carers valued mental stimulation and engaged in meaningful activities which helped them keep in touch and feel the world around them.

Given that iCST significantly improved the caregiving relationship quality and carer well-being, the programme might be a useful part of personally tailored home care packages, which may help maintain people with dementia in their own home for longer.

iCST also may be used in care homes for the person does not wish to participate in group activities or family members visit relatives in care homes.

From a clinical perspective, there are reductions in depressive symptoms and improvement in QoL in carers which can form the basis of low-cost, non-drug intervention.  This has the potential to prolong carers’ ability to provide care for the person with dementia and contribute to the cost-effectiveness of dementia care.  Enhancing the caregiving relationship through iCST may reduce carers’ “role strain” .