The effects of a Cognitive Stimulation Therapy [CST] programme for people with dementia on family caregivers’ health

BMC Geriatrics

Martin Orrell¹  Robert T Woods²  Aimee Spector³  Zoe Hoare⁴  Elisa Aguirre¹ 

[1] Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, Essex, England;DSDC Wales, Bangor University, 45 College Road, Bangor, Gwynedd LL57 2AS, Wales;Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, England;North Wales Organisation for Randomised Trials in Health [NWORTH], Institute of Medical & Social Care Research, Bangor, Wales

关键词: Quality of life;    Cognitive stimulation;    Family caregivers;    Alzheimer’s disease;    Dementia;   

Others  :  855307
DOI  :  10.1186/1471-2318-14-31

 received in 2013-07-10, accepted in 2014-02-18,  发布年份 2014

【 摘 要 】

Background

There is growing evidence that Cognitive Simulation Therapy (CST) benefits cognition and quality of life of people with dementia, but little is known about the indirect effects of this intervention on family caregivers. This study sought to investigate the effect of CST on family caregivers general health status of people with dementia living in the community attending the CST intervention.

Method

Eighty-five family caregivers of people with dementia took part in the study. All the people with dementia received the standard twice weekly seven weeks of the CST intervention plus either 24 weeks of a maintenance CST (MCST) intervention or 24 weeks of treatment as usual. Family caregivers were assessed before and after their relatives the CST programme, and after 3 and 6 months of the MCST programme. A pre and post CST groups comparison was undertaken to evaluate the open trial first phase and an ANCOVA model used to analyse the maintenance phase with its controlled comparison.

Results

We found no evidence for a benefit on the family caregiver outcome measures of the intervention before and after CST groups by using a t-test analysis or any significant differences between intervention and control groups for any of the variables considered at any time point (3 and 6 month follow up).

Conclusion

CST seems to have a relatively specific benefit fpr people with dementia that may not carry over to family carers. Future studies need to further explore and compare the effects that CST might bring to family caregivers of people with dementia attending the intervention.

Trial registration

Current Controlled Trials ISRCTN26286067

【 授权许可】

   
2014 Aguirre et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Prince M, Bryce R, Ferri C: World Alzheimer report: the benefits of early diagnosis and intervention. Alzheimer’s Disease International; 2011. http://www.alz.co.uk/worldreport2011 webcite
• [2]Van Mierlo LD, Meiland FJ, Van der Roest HG, Dröes RM: Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia. Int J Geriatr Psychiatry 2012, 27(1):1-14.
• [3]Pot AM, Deeg DJH, Van Dyck R: Psychological well-being of informal caregivers of elderly people with dementia: changes over time. Aging Ment Health 1997, 1(3):261-268.
• [4]Eagles JM, Craig A, Rawlinson F, Restall DB, Beattie JA, Besson JA: The psychological well-being of supporters of the demented elderly. Br J Psychiatry 1987, 150(3):293-298.
• [5]Schulz R, Boeerner K, Shear K, Zhang S, Gitlin L: Predictors of complicated grief among dementia caregivers: A prospective study of bereavement. Am Assoc Geriatr Psychiatry 2006, 14(8):650-658.
• [6]Gaugler JE, Kane RL, Kane RA, Newcomer R: Unmet care needs and key outcomes in dementia. J Am Geriatr Soc 2005, 53:2098-2105.
• [7]Yaffe K, Fox P, Newcomer R, Sands L, Lindquist K, Dane K, Covinsky KE: Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA 2002, 287(16):2090-2097.
• [8]Olazaran J, Reisberg B, Clare L, Cruz I, Pena-Casanova J, Del Ser T, Woods RT, Beck C, Auer S, Lai C, Spector A, Fazio S, Bond J, Kivipelto M, Brodaty H, Rojo JM, Collins H, Teri L, Mittelman M, Orrell M, Feldman HH, Muniz R: Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dement Geriatr Cogn Disord 2010, 30(2):161-178.
• [9]Livingston G, Johnston K, Katona C, Paton J, Lykestsos CG: Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry 2005, 162(11):1996-2021.
• [10]Woods B, Aguirre E, Spector A, Orrell M: Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012, (Issue 2):Art. No.: CD005562. doi:10.1002/14651858.CD005562.pub2.14
• [11]Clare L, Woods RT: Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer's disease: a review. Neuropsychol Rehabil 2004, 14:385-401.
• [12]Onder G, Zanetti O, Giacobini E, Frisoni GB, Bartorelli L, Carbone G, Lambertucci P, Silveri MC, Bernabei R: Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial. Br J Psychiatry 2005, 187:450-455.
• [13]Bottino CMC, Carvalho IAM, Alvarez AM, Avila R, Zukauskas PR, Bustamante SEZ, Andrade FC, Hototian SR, Saffi F, Camargo CHP: Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: a pilot study. Clin Rehabil 2005, 19:861-869.
• [14]Spector A, Orrell M, Davies S, Woods B: Can reality orientation be rehabilitated? Development and piloting of an evidence-based programme of cognition-based therapies for people with dementia. Neuropsychol Rehabil 2001, 11(3–4):377-397.
• [15]Schulz R, Sherwood P: Physical and Mental Health Effects of Family Caregiveing. Am J Nurs 2008, 108(9 Suppl):23-27. doi:10.1097/01.NAJ.0000336406.45248.4c
• [16]Aguirre E, Spector A, Hoe J, Russell TI, Knapp M, Woods TR, Orrell M: Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia. Trials 2010, 11:46. BioMed Central Full Text
• [17]Orrell M, Aguirre E, Spector A, Hoare Z, Streater A, Woods B, Streater A, Donovan H, Hoe J, Russell I: Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia. BMJ 2014. in press
• [18]Aguirre E, Hoare Z, Streater A, Spector A, Woods B, Hoe J, Orrell M: Cognitive Stimulation Therapy (CST) for people with dementia- who benefits most? Int J Geriatr Psychiatry 2012. doi:10.1002/gps.3823.20 Aguirre et al., 2011
• [19]Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, Orrell M: Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. Br J Psychiatry 2003, 183:248-254.
• [20]Spector A, Thorgrimsen L, Woods B, Orrell M: Making a difference: an evidence-based group programme to offer cognitive stimulation therapy (CST) to people with dementia: manual for group leaders. UK: Hawker Publications; 2006.
• [21]Aguirre E, Spector A, Hoe J, Streater A, Russell IT, Woods RT, Orrell M: Development of an evidence- based extended programme of maintenance cognitive stimulation therapy (CST) for people with dementia. Non-pharmacological Therapies in Dementia Journal 2011, 1(3):198-215.23.
• [22]Aguirre E, Spector A, Streater A, Hoe J, Woods B, Orrell M: Making a Difference 2: volume two: an evidence based group programme to offer Maintenance Cognitive Stimulation Therapy (CST) to people with dementia. UK: Hawker Publications; 2011.
• [23]Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008, 337:a1655.
• [24]The EG: EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 1990, 16(3):199-208.
• [25]Jenkinson C, Layte R: Development and testing of the UK SF-12 (short form health survey). J Health Serv Res Policy 1997, 2(1):14.
• [26]Donaldson C, Tarrier N, Burns A: The impact of the symptoms of dementia on caregivers. Br J Psychiatry 1997, 170(1):62-68.27.
• [27]Schulz R, O'Brien AT, Bookwala J, Fleissner K: Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist 1995, 35(6):771-791.
• [28]Orrell M, Woods B, Spector A: Should we use cognitive stimulation therapy to improve cognitive function in people with dementia. BMJ 2012, 344:e633. doi:10.1136/bmj.e633
• [29]Moniz-Cook E, Agar S, Silver M, Woods R, Wang M, Elston C, Win T: Can staff training reduce behavioural problems in residential care for the elderly mentally ill? Int J Geriatr Psychiatry 1998, 13(3):149-158.
• [30]Quayhagen MP, Quayhagen M, Corbeil RR, Hendrix RC, Jackson JE, Snyder L, Bower D: Coping with dementia: evaluation of four nonpharmacologic interventions. Int Psychogeriatr 2000, 12(2):249-265.