Authors (including presenting author) :
Wong Y, Cheung P, Cheung YC, Kwok HM, Tsang KY
Affiliation :
Occupational Therapy Department, Kowloon Hospital
Keyword 1: :
Cognitive Stimulation Therapy
Keyword 3: :
Mild cognitive impairment
Introduction :
Cognitive Stimulation Therapy (CST) group is non-pharmacological intervention proven to improve cognition and quality of life in elder adults with dementia (Spector et al., 2003; Wong et al., 2018). The Kowloon Hospital Occupational Therapy Department Out-patient (KHOT-OPD) adopted CST as part of the cognitive rehabilitation service.
Objectives :
This study compared the effectiveness and efficiency of CST with conventional cognitive training (CCT) in optimizing cognition, functional independence, psychological well-being, and community engagement among patients with cognitive impairments including subjective memory complaints (SMCs), mild cognitive impairment (MCI) and Dementia.
Methodology :
A retrospective review (January 2024 - August 2025) was conducted at KHOT-OPD
•CST group: 31 elderly (aged 67 to 96, mean=80.2; SMCs/MCI: n=19; dementia: n=12) who completed CST(Group-based) •CCT group: 28 elderly (aged 60 to 96, mean = 79.9; SMCs/MCI: n=17; dementia: n=11) who completed CCT(Individual-based) Independent t-test and chi square test were used to compare baseline demographics and pre-treatment scores. Paired sample t-test was used to analyze pre-post changes in Hong Kong Montreal Cognitive Assessment (HK-MoCA), Functional Independence Measure (FIM), Lawton IADL scale, WHO-Five Well-Being Index (WHO-5), and Self-efficacy Scale. Cost-effectiveness, number of sessions participated and patients who can maintain their function in the community were also compared.
Result & Outcome :
CST and CCT groups were homogenous in baseline demographics and pre-treatment scores(p>0.05). There was no significant difference between CST and CCT in cognition, functional independence, and psychological well-being maintenance (p>0.05). Both training preserved patients’ function well. CST group (1 therapist: 6 patients) was more cost-effective than CCT (1:3 ratio), benefiting more patients without compromising clinical outcomes. CST participants attended fewer sessions on average (30.38 vs. 47.96 in CCT; mean difference=17.589; 36% fewer) while achieving comparable therapeutic effect. Self-efficacy scores improved in 84% CST patients(n=26), with 85%(n=22) completed training without seeking further routine OPD cognitive training within 3 months. In contrast, 50% (n=14) CCT participants resought hospital OPD cognitive services within 3 months. These results suggest CST’s group-based, empowerment-driven, social and community engagement-focused design could efficiently promote patients' confidence to be well-maintained in the community after exiting hospital services. Increased efficiency allows resources to be spared for earlier intervention and greater service coverage to SMCs, MCI and dementia. Further studies will explore CST’s carry-over effects and contribution to integrated medical–social models of cognitive care.
