Adapting Individual Cognitive Stimulation Therapy (iCST) for Delivery by a Web-application
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 43
- 试验地点
- 8
- 主要终点
- Change in cognition (person with dementia)
研究概览
简要总结
In the UK, over 670,000 older people are living with dementia which has a substantial, multi-level impact on society, the person with dementia, and their carers. There is a need for an increase in the availability of psychological therapies since people with dementia can face difficulties with staying mentally stimulated and engaged. Cognitive Stimulation Therapy (CST) offers a person based approach and can help to relieve some of these problems. It is a brief manualised evidence based psychological treatment for people with mild to moderate dementia which has shown to improve cognition and quality of life. CST is currently available in both a group and individualised format called iCST. It is worthwhile to explore a computerised version of iCST since it would take together the added value of computer use and the beneficial effects of iCST which might produce combined, positive effects on cognition and quality of life. The investigators have spoken to people with dementia and their carers who are keen on using technology to stay mentally active and stimulated. This study sets out to develop and evaluate the potential benefits of an iCST web-application within a feasibility study. The effects on cognition and quality of life between (a) usual care and (b) iCST web-application over 11 weeks will be compared. A web-application is a website which can easily be accessed on and is compatible with computers and tablets. In order to create the most appropriate and practical web-application, the research team will work closely together with people with dementia, their carers, and the software company. An iCST web-application will compliment traditional CST by making it even more accessible since technology users will be able to access it easily on their device. Furthermore, a computerised version of iCST will by highly relevant for upcoming generations who have grown up with the use of technology.
详细描述
Scientific justification:
Since the use of technology is rapidly increasing in every aspect of many people's daily lives, previous research has already begun to investigate its application and implementation in multiple areas within dementia care. An example of an area where technology and dementia come together is computerised cognitive interventions. These types of interventions build on the added benefits of computer use such as reduced cognitive decline in older adults and lower risk of receiving a diagnosis of dementia among older men with the added benefits of using one's cognitive capacities. In a recent systematic review, Garcia-Casal et al. (2016) concluded that computerised cognitive interventions led to significant improvements in cognition, depression and anxiety among people with dementia. Computerised cognitive interventions may have more of an impact on cognition than non-computerised cognitive interventions.
In a randomised pilot trial conducted by Tárraga et al. (2006) which was included in Garcia-Casal's review, people with mild Alzheimer's Disease were allocated to a treatment group and a control group. The treatment group consisted of both a computerised cognitive stimulation programme and a non-computerised, face-to-face cognitive stimulation programme delivered in groups. The control group consisted solely of the non-computerised, cognitive stimulation programme. The results showed that that people with mild Alzheimer's Disease showed greater improvements in cognition lasting for 24 weeks in the treatment group which suggests added benefits of a computerised cognitive stimulation programme.
These positive findings suggest that it is worthwhile to continue conducting research in the area of computerised cognitive interventions. Interestingly, Garcia-Casal et al (2016) have pointed out that the area of computerised cognitive stimulation (which is an area of computerised cognitive interventions) is relatively underdeveloped. Most computerised cognitive interventions are geared towards cognitive training.
At the moment there are multiple, paper-based cognitive stimulation interventions available of which Cognitive Stimulation Therapy is being used more predominantly in the UK. CST is a brief evidence-based psychological treatment for people with mild to moderate dementia. It consists of mentally stimulating and engaging group activities which have shown to improve cognition and quality of life in a large scale randomised controlled trial. More recently, an individualised version of CST (iCST) was developed which is a home-based version of CST administered by informal carers (e.g., friends, family members). The content of the sessions is similar to those of CST. A multi-centre RCT of iCST showed no improvements in cognition and QoL for people with dementia, nor evidence of improvements in carers' mental and physical health. However, people with dementia receiving iCST reported a better relationship quality with their carer, and carers reported an improved health-related QoL. These findings indicate a need for further research to determine the effectiveness of carer-led cognitive stimulation interventions for people with dementia since most people received fewer than recommended number of iCST due to low adherence.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Person with dementia:
- •Meet Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria for dementia (American Psychiatric Association, 2013).
- •Score 10 or above on the Mini Mental State Examination (MMSE) (Folstein, Folstein, & McHugh, 1975) or score of 16 or above on the Montreal Cognitive Assessment (MoCA) (Trzepacz et al., 2015) where available.
- •Some ability to communicate and understand (e.g. ability to give informed consent)
- •Ability to speak and understand English
- •See/hear well enough to participate
- •No major physical illness or disability affecting their participation
- •Age range: 50 years - no maximum age limit
- •Availability of a tablet to the person with dementia and carer
- •Availability of a carer (or friend/befriender) to participate in the focus groups, interviews and iCST web-app sessions
- •Minimum age: 21
- •Ability to speak and understand English
- •See/hear well enough to participate
- •No major physical illness or disability affecting their participation
- •Exclusion criteria
- •Person with dementia and carer:
- •Concurrent participation in any other interventional study for people with dementia/carers
排除标准
- 未提供
结局指标
主要结局
Change in cognition (person with dementia)
时间窗: Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline
ADAS-Cog: to measure the severity of the cognitive symptoms (memory, language, praxis, attention and other cognitive abilities)
Change in quality of life (person with dementia)
时间窗: Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline
QoL-AD: self reporting questionnaire to investigate: physical health, energy, mood, living situation, memory, marriage, friends, chores, fun, money, self and life).
Change in general health outcome (carer)
时间窗: Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline
EQ-5D: An instrument used to measure health outcome, it provides a descriptive profile for health status. It evaluates quality of life in carers.
次要结局
- Depression/anxiety (carer)(Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline)
- Depression (person with dementia)(Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline)
- Relation between person with dementia and carer (both)(Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline)
- Behavioural symptoms (person with dementia)(Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline)
- Activities of daily living (person with dementia)(Pre-intervention (baseline), 5 weeks post baseline, 11 weeks post baseline)