Comparative Effectiveness of 3 Settings of Cognitive Stimulation Therapy on Cognition and Quality of Life for People With Dementia: A Systematic Review and Network Meta-analysis |
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| Affiliation: | 1. School of Nursing, Peking University, Beijing, China;2. Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, MD, USA;1. University of Sydney, Faculty of Health and Medicine, Sydney, Australia;2. University Centre for Rural Health, Lismore, Australia;3. Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;4. Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands;1. Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea;2. Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA;3. Health Law Institute, Mitchell Hamline School of Law, Saint Paul, MA, USA;4. A.G. Rhodes Health and Rehab, Atlanta, GA, USA;5. Center for Nursing Excellence in Palliative Care, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA |
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| Abstract: | ![]()
ObjectiveTo compare and rank the effectiveness of group cognitive stimulation therapy (group CST), maintenance cognitive stimulation therapy (MCST), and individual cognitive stimulation therapy (iCST) on cognition and quality of life (QoL) in people with dementia.DesignSystematic review and network meta-analysis (NMA).Setting and ParticipantsAll published randomized controlled trials (RCTs) that compared the differences among 3 different settings of CST or a control group in treating people with dementia.MethodsRelevant electronic databases, including PubMed, Embase, Cochrane Library for clinical trials, Web of Science, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure (CNKI), and Wanfang Data were systematically searched from inception to March 2021. RCTs that compared the differences among 3 different settings of CST or a control group in treating people with dementia were included. Then, a pairwise and network meta-analysis was conducted to evaluate the relative effects and rank probability of different CST settings. PRISMA guidelines were used for abstracting data, and the Cochrane Risk of Bias tool was used to assess data quality.ResultsIn total, 17 studies were included, which enrolled 1680 participants. Compared with the control group, MSCT [standardized mean difference (SMD) = 1.39, 95% CI 0.86, 1.91; low-quality evidence] and group CST (SMD 0.62, 95% CI 0.39, 0.84; very low-quality evidence) could significantly improve cognitive function. MCST (SMD 1.00, 95% CI 0.16, 1.85; low-quality evidence) and group CST (SMD 0.53, 95% CI 0.13, 0.92; low-quality evidence) demonstrated a statistically significant effect in improving the QoL, whereas iCST was not significantly inferior to the control condition. None of the treatments were significantly different from each other with respect to acceptability.Conclusions and ImplicationsFor people with dementia, group CST and MCST seems to promote more consistent benefits in terms of cognition and QoL than the iCST, and MCST was likely to be the most effective CST setting. Further RCTs with respect to the MCST and iCST efficacy are needed. |
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| Keywords: | Dementia cognitive stimulation therapy network meta-analysis systematic review |
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