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Dementia of Alzheimer TypeNCT05394584

CST-HK for Cognition and Well-being in People With Dementia

A study testing Cognitive Stimulation Therapy in people with Dementia of Alzheimer Type, run by The University of Hong Kong at 1 site in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This cluster wait-list randomized controlled study investigates the effectiveness of Cognitive Stimulation Therapy (Hong Kong version) delivered by trained supportive staff and volunteers for people in maintaining the quality of life and cognition in people with mild-to-moderate cognitive impairment in community and… Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Dementia of Alzheimer Type
What is being tested?
Cognitive Stimulation Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
129 participants
Where
1 siteHong Kong
Study dates
1 Jun 2018to 13 Jul 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Having a clinical diagnosis of mild-to-moderate dementia, or a cognitive assessment result suggestive of mild-to-moderate cognitive impairment;
  • Being able to communicate and understand Cantonese;
  • Being able to hear and see well enough to participate in cognitive stimulation activities;
  • Having a caregiver who is able to give joint informed consent.

Who cannot join

  • Having major illness(es) that would affect participation (e.g., clinically significant depressive symptoms or psychotic disorders);
  • Having behavioural and psychological symptoms (e.g., aggression, inappropriate sexual behaviours, hallucination, delusion) that would interfere with participation in the intervention.

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • Hong Kong Young Women's Christian Association

    Hong Kong, 999077

Other trials in Hong Kong

About this study

Official title: The Implementation of Cognitive Stimulation Therapy Hong Kong Version (CST-HK) for Promoting Cognitive Functioning and Psychosocial Well-being of People With Dementia

This cluster wait-list randomized controlled study investigates the effectiveness of Cognitive Stimulation Therapy (Hong Kong version) delivered by trained supportive staff and volunteers for people in maintaining the quality of life and cognition in people with mild-to-moderate cognitive impairment in community and residential care settings.

Read the detailed description

Non-pharmacological interventions such as cognitive training, cognitive rehabilitation, and cognitive stimulation aim at slowing down the cognitive decline experienced by a person with dementia. Cognitive stimulation involves a range of group activities and discussions to enhance general cognitive and social functioning. A meta-analysis of 15 studies with a total of 718 persons with dementia showed evidence of benefits of cognitive stimulation on cognitive function, quality of life, and self-reported well-being of the people with dementia . The benefits appeared to add on to medication effects. The clinical improvements in verbal and visual memory, orientation, and auditory comprehension after cognitive stimulation appeared to be able to translate into improvements in real world activity, as seen in enhancement of the communication and social interaction of persons with dementia.

In view of the current evidence, cognitive stimulation is recommended by the National Institute for Health and Clinical Excellence and the Alzheimer's Disease International as an evidence-based, non-pharmacological intervention to be offered to all people with mild-to-moderate dementia. A standard protocol of cognitive stimulation therapy with evidence is a 7-week intervention developed by Spector and her colleagues. It is a series of standardized, well-structured stimulating activities, implemented in a sensitive, respectful and person-centered manner. Group CST typically involves 14 sessions of 45-minute group activities that required cognitive processing delivered over a 7-week period (2 sessions per week, with approximately 45 mins per session). The group size was standardized to be 6 to 8 persons. People with dementia would participate in each of the 14 designated theme activities during each session. The activities aimed at stimulating and engaging persons with dementia in an active way, and providing an optimal learning environment and the positive social benefits of group therapy. Cognitive stimulation therapy can be delivered by non-specialist healthcare workers with minimum training . This allows CST to be used in low-resource environment. Manuals in different languages had been published for the group leaders to follow. Due to this advantage of high reproducibility with high quality evidence support, CST was widely adopted in over 20 countries.

In Hong Kong, there is currently no recommendations or routine provision of cognitive stimulation. In 2015, the standard group CST protocol was culturally adapted for and tested in Chinese people with dementia in Hong Kong (CST-HK). The observed improvements in cognitive outcome was in line with that of overseas studies. The protocol appeared to be feasible and acceptable to Hong Kong Chinese, with high attendance rate (92%) and low attrition rate (13%). Cultural issues identified in the pilot have been published and recommendations were made in adapting the protocol to the Hong Kong cultural settings. A Hong Kong Chinese version of the manual for CST group leaders has been published in 2017.

This study aims to investigate the effectiveness of CST-HK delivered by trained non-professional group leaders in maintaining the quality of life and cognition of people with mild-to-moderate cognitive impairment . As part of project evaluation, it aims to test the effectiveness of CST-HK compared with a wait-list control group who will receive care as usual during the waiting period.

Research Objectives The research aims to investigate the effectiveness of CST-HK among people with mild-to-moderate cognitive impairment in Hong Kong in a larger scale across service settings. It also aims to explore the effectiveness of CST-HK delivered by non-professional staff, as a possible solution to address the shortage of specialized healthcare manpower and increasing demands of non-pharmacological interventions for people with dementia.

Hypotheses The research hypothesized that, compared with the wait-list control group, the group who have received a 7-week (14-session) CST-HK intervention delivered by trained non-professional staff will show greater improvement or maintenance of (1) quality of life; and (2) cognitive performance.

Being tested
Cognitive Stimulation Therapy
Keywords
Cognitive Stimulation Therapy, Cognitive Functioning, Psychological Wellbeing

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cognitive Stimulation TherapyBehavioural

    Cognitive stimulation therapy is a non-pharmacological intervention for people with dementia at mild to moderate stages. Group cognitive stimulation therapy is a 14-session intervention delivered twice every week for 7 weeks. In each session, mentally stimulating activities are conducted around a specific themed, such as current affairs, word association, categorising objects, and number game. Each group consists of eight people with similar levels of cognitive impairment, facilitated by two group leaders who lead the activities according to 18 key principles of the therapy, including new associations, opinions rather than facts, implicit learning, and person-centred.

Study groups in NCT05394584
Study groupRoleWhat they receive
CST groupExperimentalA total of 64 people with mild-to-moderate cognitive impairment will receive group cognitive stimulation therapy (CST), which consists of 14 sessions of mentally stimulating activities delivered two times a week for 7 weeks by supportive staff and volunteers trained in CST, on top of their usual care in community centres or residential care homes.
Receives: Behavioral: Cognitive Stimulation Therapy
Usual care groupNo interventionA total of 64 people with mild-to-moderate cognitive impairment will receive the usual care in community centres or residential care homes.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quality of Life in Alzheimer's Disease

    A 13-item scale for self-rating and proxy rating on the quality of life of persons with dementia. The total score ranges from 3 to 52, higher scores means a better outcome.

    Measured: Change from Baseline Quality of Life in Alzheimer's Disease at 8 weeks

  2. Alzheimer's Disease Assessment Scale- Cognitive Subscale

    A cognitive function assessment scale for people with dementia covering 11 cognitive domains. The total score ranges from 0 to 70, higher score represents worse outcome.

    Measured: Change from Baseline Alzheimer's Disease Assessment Scale- Cognitive Subscale at 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 May 2022
  2. Study start1 Jun 2018
  3. Primary completion13 Jul 2021
  4. Study completion13 Jul 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a cluster randomized wait-list control study.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
129 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05394584
Sponsor's protocol ID
EA1802054
Status last verified
May 2022
First submitted
17 May 2022
Last updated
27 May 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Aguirre E, Woods RT, Spector A, Orrell M. Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomised controlled trials. Ageing Res Rev. 2013 Jan;12(1):253-62. doi: 10.1016/j.arr.2012.07.001. Epub 2012 Aug 7.

    PubMed 22889599
  • Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database Syst Rev. 2013 Jun 5;2013(6):CD003260. doi: 10.1002/14651858.CD003260.pub2.

    PubMed 23740535
  • Chan IW, Chu LW, Lee PW, Li SW, Yu KK. Effects of cognitive function and depressive mood on the quality of life in Chinese Alzheimer's disease patients in Hong Kong. Geriatr Gerontol Int. 2011 Jan;11(1):69-76. doi: 10.1111/j.1447-0594.2010.00643.x. Epub 2010 Aug 25.

    PubMed 20738410
  • Chu LW, Chiu KC, Hui SL, Yu GK, Tsui WJ, Lee PW. The reliability and validity of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the elderly Chinese in Hong Kong. Ann Acad Med Singap. 2000 Jul;29(4):474-85.

    PubMed 11056778
  • Hall L, Orrell M, Stott J, Spector A. Cognitive stimulation therapy (CST): neuropsychological mechanisms of change. Int Psychogeriatr. 2013 Mar;25(3):479-89. doi: 10.1017/S1041610212001822. Epub 2012 Nov 12.

    PubMed 23146408
  • Khan Z, Corbett A, Ballard C. Cognitive stimulation therapy: training, maintenance and implementation in clinical trials. Pragmat Obs Res. 2014 Apr 5;5:15-19. doi: 10.2147/POR.S56000. eCollection 2014.

    PubMed 27774025
  • Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002 May-Jun;64(3):510-9. doi: 10.1097/00006842-200205000-00016.

    PubMed 12021425
  • National Collaborating Centre for Mental Health (UK). Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care. Leicester (UK): British Psychological Society (UK); 2007. Available from http://www.ncbi.nlm.nih.gov/books/NBK55459/

    PubMed 21834193
  • Orrell M, Hoe J, Charlesworth G, Russell I, Challis D, Moniz-Cook E, Knapp M, Woods B, Hoare Z, Aguirre E, Toot S, Streater A, Crellin N, Whitaker C, d'Amico F, Rehill A. Support at Home: Interventions to Enhance Life in Dementia (SHIELD) - evidence, development and evaluation of complex interventions. Southampton (UK): NIHR Journals Library; 2017 Feb. Available from http://www.ncbi.nlm.nih.gov/books/NBK424174/

    PubMed 28211659
  • Paddick SM. Cognitive stimulation therapy as a low-resource intervention for dementia in sub-saharan africa: Initial results of a controlled trial. Alzheimer's & Dementia: The Journal of the Alzheimer's Association 11(7):607, 2015.

  • Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: The benefits of early diagnosis and intervention. Alzheimer's Disease International (ADI) 2011.

  • Prince M, Wimo A, Guerchet M, Ali G, Wu Y, Prina M. World Alzheimer Report 2015-The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. Alzheimer's Disease International (ADI) 2015.

  • Spector A, Orrell M, Woods B. Cognitive Stimulation Therapy (CST): effects on different areas of cognitive function for people with dementia. Int J Geriatr Psychiatry. 2010 Dec;25(12):1253-8. doi: 10.1002/gps.2464.

    PubMed 20069533
  • Spector A, Thorgrimsen L, Woods B, Orrell M. Making a difference: An evidence-based group program to offer cognitive stimulation therapy (CST) to people with dementia; the manual for group leaders (text in chinese). Hong Kong: Hong Kong University Press 2017.

  • Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, Orrell M. Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. Br J Psychiatry. 2003 Sep;183:248-54. doi: 10.1192/bjp.183.3.248.

    PubMed 12948999

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive Stimulation Therapy in people with Dementia of Alzheimer Type, run by The University of Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality of Life in Alzheimer's Disease (time frame: Change from Baseline Quality of Life in Alzheimer's Disease at 8 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05394584, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 May 2022.

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