An enjoyable programme of cognitive stimulation improves both cognitive skills and the quality of life of dementia patients.
pharmaceutical approaches yet to deliver substantial benefits to dementia patients, psychosocial interventions may offer an alternative route to protect memory and other cognitive skills. Indeed, a cognitive stimulation programme developed by Professor Martin Orrell, Dr Aimee Spector and colleagues has been shown to provide multiple benefits, and has now been widely implemented in the UK and internationally.
Professor Orrell became interested in cognitive stimulation therapy while undertaking a systematic review of mental stimulation approaches in dementia. The evidence suggested that such approaches had a positive impact on cognitive skills and quality of life, and were also cost-effective. What was lacking, however, were large-scale multicentre trials to confirm these promising findings.
Drawing on best practice from these studies, Professor Orrell went on to develop a seven-week cognitive stimulation programme, delivered in groups, with accompanying manual and DVD. Randomised controlled trials confirmed that the programme improved cognition and quality of life at least as well as pharmaceutical interventions. It was positively received by patients and carers, was practical to deliver and cost-effective.
The programme aims to be engaging and enjoyable. It makes extensive use of puzzles to get mental juices flowing, touching upon areas such as money management, current affairs and diet. The programme, Making a Difference, now in its second incarnation, has been endorsed by the National Institute for Health and Care Excellence (NICE) and recommended by Alzheimer's Disease International. It is in widespread use across the UK and has been adapted for other cultures, being used in at least 15 other countries.
Professor Orrell is continuing to work on cognitive stimulation therapy. Recent studies have suggested that longer-term use of six months delivers additional benefits, and notably that it acts synergistically with drug treatments for Alzheimer's disease.
As well as additional work on the training needs of programme facilitators, he has also begun a major programme to examine the effectiveness of individual cognitive stimulation therapy - a more flexible approach that carers could use with people with dementia. As group therapy is not suitable for all patients, the individual course could bring the benefits of cognitive stimulation therapy to much larger numbers of people.