Authors (including presenting author) :
KWAN TK(1), MAN MH(1), LAU WM(1)
Affiliation :
(1)Occupational Therapy Department, Kwong Wah Hospital
Keyword 1: :
Cognitive Stimulation Therapy
Keyword 2: :
major Neurocognitive Disorder
Keyword 3: :
cognitive training
Introduction :
CST is an evidence-based intervention for improving cognition in major NCD individuals. While the standard protocol delivered 14 sessions twice weekly, local resource constraints often limit to once weekly. Evidence supporting weekly CST is limited, with two UK studies reported conflicting results: a 2014 RCT showed no significant cognitive or quality-of-life benefits, whereas a 2024 study reported improvements in psychoaffective symptoms.
Objectives :
This study therefore examined the effectiveness of once-weekly CST compared with conventional training in Chinese individuals with major NCD.
Methodology :
22 patients were recruited via convenience sampling from Geriatric Day Hospital in Kwong Wah Hospital. 11 participants received weekly CST for 14 sessions, while 11 controls received weekly conventional cognitive training. Inclusion criteria were a DSM-V diagnosis of major NCD and ability to follow instructions; exclusion criteria included sensory impairments or disruptive behaviors. Primary outcome measures included the HK-MoCA or the HK-MoCA-5, and Holden Communication Scale (HCS).
Result & Outcome :
The mean age was 83.3 in the intervention group and 83.9 in the control group, with females comprising 54.5% of both groups. Mean score of Functional Assessment Staging (FAST) scores were 4.27 and 4.72 respectively, indicating mild to moderate Alzheimer’s disease. Between-group analysis showed significant improvements in both HCS total and HCS “awareness and knowledge” subscale (p=0.02). No significant differences were found for HK-MoCA or other HCS subscales (p>0.05). Within-group analysis showed significant improvements in the intervention group, with HK-MoCA and HCS scores increasing from 9.67 to 14.89 (p< 0.01) and 15.64 to 7.64 (p< 0.01) respectively. All HCS subscales also improved significantly, including conversation (6.36 to 2.09, p< 0.01), awareness and knowledge (5.45 to 3.73, p=0.03), and communication (3.82 to 1.73, p< 0.01). Conversely, there are no significant improvements in HK-MoCA (p=0.72), HCS total or subscales (p=0.18, p>0.05) in the control group. Weekly CST is effective in improving cognition in Chinese individuals with major NCD. It is more effective in improving communication than conventional cognitive training, particularly in awareness and knowledge. Such protocol may represent an effective cognitive rehabilitation approach in local resource-limited settings.
