3.5 Evaluation of CST

Aim

The literature regarding the effectiveness of CST for individuals with dementia will be critically evaluated.

Learning outcomes

After completing the module, you will know:

• How CST was evaluated,
• Which are the main results of CST evaluation.

Introduction

Several studies have been conducted to evaluate the effectiveness and the usefulness of CST internationally. The literature search showed that more than 120 papers have been written, concerning CST evaluation. Some of these surveys were conducted in UK, Hong Kong, Japan, Tanzania and Portugal. Below the common results among these surveys are presented ^[1,2].

3.5.1 Cognitive improvement

Based on various systematic reviews on CST, it was found an indication of improved cognition. The commonly used tools, Mini Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale-Cognition (ADAS-Cog), ask a number of questions to ascertain cognitive status of people with dementia. More precisely, these tests primarily investigate memory and orientation, but also language and visual/spatial abilities before and after the CST treatment. The systemic literature review on CST, shows a significant positive impact in cognitive functioning and more precisely in memory, orientation and comprehension of syntax ^[3,4].

3.5.2 Quality of life

A person’s well-being is considered as a key issue in many aspects of dementia care. Besides the significant improvement in cognitive function, CST intervention offers to individuals with dementia, an enhancement in the quality of their lives (QoL). More specifically, 201 people with dementia living in residential homes or attending day centres were assessed using the Quality of Life-Alzheimer’s Disease scale (QOL-AD) measuring the level of cognition, mood, communication, and dependency to the carer. The impressive results showed that the improvement of QoL had a significant positive correlation with lower levels of dependency and depression, as well as with greater willingness to engage in conversation and communication ^[4,5].

3.5.3 Cost-effectiveness

Cost-effectiveness analyses for the CST trials were conducted by researchers at the London School of Economics and Political Science (LSE). These studies found that CST is more cost-effective than usual care, especially when looking at benefits in cognition and quality of life ^[5].

Synopsis

Key points:

• CST evaluation showed changes and more specifically an improvement in thinking skills, in the quality of patients’ daily life, and offers value for money.