An occupational therapy perspective on cognitive stimulation therapy: targeting occupational performance and outcomes for people with dementia.

Introduction: Cognitive Stimulation Therapy (CST) is an activity-based intervention recommended in the United Kingdom for people with dementia. There is evidence that CST benefits cognition and quality of life, but knowledge about its effect on performance of activities of daily living (ADL) remains limited. Objective: The principal objective was to deliver CST, whilst investigating occupational performance as an additional outcome. Method: Ethical approval was obtained for this mixed methods study. Following a survey and interviews with occupational therapists and a case study of CST, an intervention (OT-CSTdem) was developed to deliver standardised CST within an occupation-centred framework. One programme of OT-CSTdem was delivered as part of routine care by a trained occupational therapist. The Assessment of Motor and Process Skills (AMPS) was used to examine any changes that took place in the occupational performance of participants (n=7). Results: Wilcoxon Signed Rank tests revealed a statistically significant increase in ADL motor ability (z = - 2.214, p = 0.027) with a large effect size (r = 0.639). An increase in ADL process ability was also noted, that was close to significance and with a large effect size (z = - 1.184, p = 0.066, r = 0.531). Conclusion: The results of this small exploratory study are promising and provide initial evidence of added value when CST is delivered within an occupation-centred framework, as regards supporting the occupational performance of people with dementia. Further research is recommended to investigate whether these outcomes can be reproduced with a larger sample.