The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial

Martin Orrell; Lauren Yates; Phuong Leung; Sujin Kang; Zoe Hoare; Christopher Whitaker; Alistair Burns; Martin  Knapp; Iracema Leroi; Esme Moniz-Cook; Stephen  Pearson; Stephen Simpson; Aimee Spector; Stephen Roberts; Ian  Russell; Hugo  de Waal; Robert Woods; Vasiliki Orgeta

doi:10.1371/journal.pmed.1002269

The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial

Martin Orrell
, Lauren Yates
, Phuong Leung
, Sujin Kang
, Zoe Hoare
, Christopher Whitaker
, Alistair Burns
, Martin Knapp
, Iracema Leroi
, Esme Moniz-Cook
, Stephen Pearson
, Stephen Simpson
, Aimee Spector
, Stephen Roberts
, Ian Russell
, Hugo de Waal
, Robert Woods
, Vasiliki Orgeta

University of Nottingham
University College London
Manchester Academic Health Sciences Centre
London School of Economics
University of Hull
Devon Partnership NHS Trust, Devon
Dorset Healthcare University NHS Foundation Trust, Dorset
Lincolnshire Partnership NHS Foundation Trust, Lincoln
Swansea University
Norfolk & Suffolk NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Cognitive Stimulation Therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that homebased programmes of cognitive stimulation delivered by family caregivers may
benefit both the person and the caregiver. However, no previous studies have
evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual Cognitive Stimulation Therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (wellbeing) for the caregiver.
Methods and Findings
A single-blind, pragmatic randomized trial (RCT) at eight study sites across the UK. The intervention and blinded assessment of outcomes were conducted in
participants’ homes. 356 people with mild to moderate dementia and their caregivers recruited from memory services, and community mental health teams. Participants were randomly assigned to iCST (75, 30 minute sessions) or treatment as usual (TAU) control over 25 weeks. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher.
Primary outcomes were cognition (Alzheimer’s Disease Assessment Scale –
cognitive [ADAS-Cog]) and self-reported quality of life (QoL) (Quality of Life
Alzheimer’s Disease [QoL-AD]) for the person with dementia, and general health
status (Short Form-12 [SF-12]) for the caregiver. Secondary outcomes included:
quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationships Scale), and health-related QoL (EQ5D) for the caregiver.

Original language	English
Journal	PLoS Medicine
DOIs	https://doi.org/10.1371/journal.pmed.1002269
Publication status	Published - 28 Mar 2017

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Cite this

Orrell, M., Yates, L., Leung, P., Kang, S., Hoare, Z., Whitaker, C., Burns, A., Knapp, M., Leroi, I., Moniz-Cook, E., Pearson, S., Simpson, S., Spector, A., Roberts, S., Russell, I., de Waal, H., Woods, R., & Orgeta, V. (2017). The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1002269

@article{16a38be2ab7940bba0a5d73160ebfc4d,

title = "The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial",

abstract = "Background Cognitive Stimulation Therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that homebased programmes of cognitive stimulation delivered by family caregivers may benefit both the person and the caregiver. However, no previous studies have evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual Cognitive Stimulation Therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (wellbeing) for the caregiver. Methods and Findings A single-blind, pragmatic randomized trial (RCT) at eight study sites across the UK. The intervention and blinded assessment of outcomes were conducted in participants{\textquoteright} homes. 356 people with mild to moderate dementia and their caregivers recruited from memory services, and community mental health teams. Participants were randomly assigned to iCST (75, 30 minute sessions) or treatment as usual (TAU) control over 25 weeks. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher. Primary outcomes were cognition (Alzheimer{\textquoteright}s Disease Assessment Scale – cognitive [ADAS-Cog]) and self-reported quality of life (QoL) (Quality of Life Alzheimer{\textquoteright}s Disease [QoL-AD]) for the person with dementia, and general health status (Short Form-12 [SF-12]) for the caregiver. Secondary outcomes included: quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationships Scale), and health-related QoL (EQ5D) for the caregiver.",

author = "Martin Orrell and Lauren Yates and Phuong Leung and Sujin Kang and Zoe Hoare and Christopher Whitaker and Alistair Burns and Martin Knapp and Iracema Leroi and Esme Moniz-Cook and Stephen Pearson and Stephen Simpson and Aimee Spector and Stephen Roberts and Ian Russell and \{de Waal\}, Hugo and Robert Woods and Vasiliki Orgeta",

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Orrell, M, Yates, L, Leung, P, Kang, S, Hoare, Z, Whitaker, C, Burns, A, Knapp, M, Leroi, I, Moniz-Cook, E, Pearson, S, Simpson, S, Spector, A, Roberts, S, Russell, I, de Waal, H, Woods, R & Orgeta, V 2017, 'The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial', PLoS Medicine. https://doi.org/10.1371/journal.pmed.1002269

TY - JOUR

T1 - The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia

T2 - A randomized controlled trial

AU - Orrell, Martin

AU - Yates, Lauren

AU - Leung, Phuong

AU - Kang, Sujin

AU - Hoare, Zoe

AU - Whitaker, Christopher

AU - Burns, Alistair

AU - Knapp, Martin

AU - Leroi, Iracema

AU - Moniz-Cook, Esme

AU - Pearson, Stephen

AU - Simpson, Stephen

AU - Spector, Aimee

AU - Roberts, Stephen

AU - Russell, Ian

AU - de Waal, Hugo

AU - Woods, Robert

AU - Orgeta, Vasiliki

PY - 2017/3/28

Y1 - 2017/3/28

N2 - Background Cognitive Stimulation Therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that homebased programmes of cognitive stimulation delivered by family caregivers may benefit both the person and the caregiver. However, no previous studies have evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual Cognitive Stimulation Therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (wellbeing) for the caregiver. Methods and Findings A single-blind, pragmatic randomized trial (RCT) at eight study sites across the UK. The intervention and blinded assessment of outcomes were conducted in participants’ homes. 356 people with mild to moderate dementia and their caregivers recruited from memory services, and community mental health teams. Participants were randomly assigned to iCST (75, 30 minute sessions) or treatment as usual (TAU) control over 25 weeks. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher. Primary outcomes were cognition (Alzheimer’s Disease Assessment Scale – cognitive [ADAS-Cog]) and self-reported quality of life (QoL) (Quality of Life Alzheimer’s Disease [QoL-AD]) for the person with dementia, and general health status (Short Form-12 [SF-12]) for the caregiver. Secondary outcomes included: quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationships Scale), and health-related QoL (EQ5D) for the caregiver.

AB - Background Cognitive Stimulation Therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that homebased programmes of cognitive stimulation delivered by family caregivers may benefit both the person and the caregiver. However, no previous studies have evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual Cognitive Stimulation Therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (wellbeing) for the caregiver. Methods and Findings A single-blind, pragmatic randomized trial (RCT) at eight study sites across the UK. The intervention and blinded assessment of outcomes were conducted in participants’ homes. 356 people with mild to moderate dementia and their caregivers recruited from memory services, and community mental health teams. Participants were randomly assigned to iCST (75, 30 minute sessions) or treatment as usual (TAU) control over 25 weeks. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher. Primary outcomes were cognition (Alzheimer’s Disease Assessment Scale – cognitive [ADAS-Cog]) and self-reported quality of life (QoL) (Quality of Life Alzheimer’s Disease [QoL-AD]) for the person with dementia, and general health status (Short Form-12 [SF-12]) for the caregiver. Secondary outcomes included: quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationships Scale), and health-related QoL (EQ5D) for the caregiver.

U2 - 10.1371/journal.pmed.1002269

DO - 10.1371/journal.pmed.1002269

M3 - Article

SN - 1549-1676

JO - PLoS Medicine

JF - PLoS Medicine

ER -

The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomized controlled trial

Abstract

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