Constructive engagement in cognitive stimulation therapy groups among people with dementia: A mixed-methods study

Area of Science:

• Gerontology
• Neuroscience
• Psychology

Background:

• Clinical guidelines recommend personalized activities and group Cognitive Stimulation Therapy (CST) for persons with dementia.
• Constructive Engagement (CE) is theoretically crucial for the efficacy of these interventions but its temporal dynamics and contributing factors are unknown.
• This study investigates changes in CE during CST and its determinants.

Purpose of the Study:

• To examine the changes in constructive engagement (CE) over time during group Cognitive Stimulation Therapy (CST) for persons with dementia.
• To identify factors that contribute to constructive engagement during CST.

Main Methods:

• A mixed-methods approach was employed, combining time sampling of engagement levels in persons with dementia (n=113) across CST phases.
• Repeated measures ANOVA was used to analyze changes in engagement over time.
• Qualitative thematic analysis of facilitator interviews (n=12) explored contributors to CE.

Main Results:

• Persons with dementia spent approximately 51% of their time in constructive engagement and 46% in passive engagement.
• CE remained stable throughout the 14-session CST, with a slight increase from the early to middle phase.
• Baseline age, cognitive function, and activities of daily living correlated with CE, while gender and education did not.

Conclusions:

• Group CST effectively engages persons with dementia, with CE remaining relatively stable.
• Facilitator skills in tailoring activities and utilizing group dynamics can enhance CE.
• Further research should explore CE as a mechanism for improving intervention outcomes in dementia care.