Different durations of cognitive stimulation therapy for Alzheimer’s disease: a systematic review and meta-analysis

Figures & data

Table 1 Baseline of included studies

Year	First author	Study design	Principle health problem	Mean age in years	SEX	MMSE Inclusion criteria	Final sample size	Intervention	Duration	Control	Main outcomes	Main findings	Risk of bias
2016	Domingo J	Double-blind RCT	AD	No mention	M/F (54/66)	≥18	120	MBAS+ChEIs; CST+ChEIs;PMR+ChEIs	2 years	ChEIs	MMSE; CAMCOG	The mindfulness group showed significant scores compared with the control and muscle relaxation groups. Group cognitive stimulation evolved better than the control group but not better than the muscle relaxation group.	low
2015	D’Onofrio	single-blind RCT	AD	78.19	M/F (42/48)	≥10	90	CST+ChEIs	6-month	ChEIs	MMSE;CDR;HAMD;NPI	The study showed that the integrated treatment of RTP with CS in AD patients for 6 months improved significantly cognition, depressive and neuropsychiatric symptoms, fuctional status, and mortality risk in comparison with a group of AD patients receiving only RTP.	low
2006	L Ta´rraga	Single-blind, pilot RCT	AD	76.7	F (84.78)	18–24	43	CST+ChEIs	24 weeks	ChEIs	ADAS-Cog;MMSE	Cognitive stimulation treatment improved cognition in patients who were treated with a stable dose of ChEI, compared with those who were treated only with ChEIs.	Unclear
2006	Osamu Matsuda	A single-blind RCT	AD	70.77	M/F (10/20)	No mention	30	CST+ChEIs	1 year	ChEIs	MMSE	The results of this study suggest that CST may be an important component of therapy for mild AD treated with acetylcholinesterase inhibitors.	Unclear
2010	Yi-Xuan Niu	Rater-blind RCT	Mild to moderate AD	79.85	M/F (25/7)	10–24	32	CST+ChEIs	10 weeks	ChEIs	NPI; MMSE	The study showed that cognitive stimulation therapy has significant efficacy in lowering apathy and depression symptomatology and in the Mini Mental State Examination in patients with mild to moderate AD.	Low

Abbreviations: AD, Alzheimer’s disease; CST, cognitive stimulation therapy; ChEIs, acetylcholinesterase inhibitor; MMSE, Mini-Mental State Examination; RCT, randomized controlled trials; ADAS-Cog, Alzheimer’s Disease Assessment Scale-cognitive; NPI, neuropsychiatric inventory; MBAS, The mindfulness-based Alzheimer's stimulation; PMR, progressive muscle relaxation; CAMCOG, Cambridge Cognitive Examination; CDR, Clinical Dementia Rating; HAMD, Hamilton Rating Scale for Depression; RTP, rivastigmine transdermal patch.

Figure 1 PRISMA flow chart of the literature screening and selection process.

Abbreviations: AD, Alzheimer's disease; RCTS, randomized controlled trials.

Figure 2 Risk of bias graph.

Figure 3 Risk of bias summary.

Figure 4 Forests plots for comparison of CST plus ChEIs versus ChEIs alone assessed by MMSE.

Abbreviations: CST, cognitive stimulation therapy; ChEIs, acetylcholinesterase inhibitor; MMSE, Mini-Mental State Examination.

Figure 5 Forests plots for comparison of CST plus ChEIs versus ChEIs alone assessed by NPI.

Abbreviations: CST, cognitive stimulation therapy; ChEIs, acetylcholinesterase inhibitor; NPI, neuropsychiatric inventory.

Figure 6 Forest plots for the comparison of short-term/maintenance/long-term CST plus ChEIs and ChEIs alone in MMSE.

Abbreviations: CST, cognitive stimulation therapy; ChEIs, acetylcholinesterase inhibitor; MMSE, Mini-Mental State Examination.