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Department of Psychological Medicine

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Presentation on theme: "Department of Psychological Medicine"— Presentation transcript:

1 Department of Psychological Medicine
Living Well with Dementia: Options and Approaches Cognitive Stimulation Dr Gary Cheung Old Age Psychiatrist Department of Psychological Medicine

2 Outline What is cognitive stimulation?
Cognitive Stimulation Therapy (CST) Recommendations for a cognitively active lifestyle Social health & risk of dementia

3 Non pharmacological approaches in Dementia
Cognitive Intervention (individual or group) Cognitive training Cognitive stimulation Cognitive rehabilitation Physical Exercise (individual or group) Aerobic exercise Strength exercise Le attuale prospettive non farmacologiche sempre insieme ad una corretta aliimentazione sono l’esercizio fisico ed il training cognitivo…... Un’ipotesi e’ se tale prospettive sono in grado di migliore l’IR cerebrale traducendo in una stabilita’ nonche’ un miglioramento delle funzioni cognitive.

4 Cognitive stimulation, usually in a group format, engagement of activities and discussions aimed at enhancing cognitive and social functioning Cognitive training individual approach practice of standard tasks; a range of difficulty levels within the standard set of tasks to suit individual’s level of ability Cognitive rehabilitation individual approach emphasis based on improving performance in everyday life rather than on cognitive tests

5 CST (Spector et al. 2003) A structured group treatment for people with mild to moderate dementia Theoretical concepts of reality orientation, validation, reminiscence, and cognitive stimulation Number of participants per group 7-8 Sessions twice a week for 7 weeks Maintenance – (optional) – sessions once a week for 24 weeks Both community and residential care settings Delivered by health professionals

6 CST: Evidence & Guidelines
World Alzheimer Report 2011 Cochrane Review 2012 UK’s NICE Guidelines Lancet commissioned report (Livingstone et al. 2017) “Cognitive stimulation therapy is the psychological approach with the strongest evidence for improving cognition.”

7 13.30-14.30 Friday Millennium 2 What is Cognitive Stimulation Therapy?
A workshop for persons with dementia and their whānau/family. Health professionals welcome.

8

9 Recommendations for a cognitively active lifestyle (LaRue 2010)
Make time for cognitively stimulating activities that you’ve always enjoyed. Rationale: Continuing favorite activities can ensure sustainability of cognitive stimulation. Long term exposure to cognitive stimulation may be needed for practical functional benefits.

10 Recommendations for a cognitively active lifestyle (LaRue 2010)
Add some new cognitive challenges, as your time and enjoyment permit. Rationale: Trying new activities may enhance brain plasticity by requiring new learning or development of new cognitive strategies.

11 Recommendations for a cognitively active lifestyle (LaRue 2010)
Aim to engage in cognitively stimulating activities several times a week or more…generate some “mental sweat.” Rationale: Current knowledge does not permit a prescription for how often or how long individuals should engage in cognitively stimulating activities. However, studies suggest that more is better, within clinically reasonable limits.

12 Recommendations for a cognitively active lifestyle (LaRue 2010)
Be aware that there is no one cognitive activity, or combination of activities, that is uniquely good for reducing dementia risk.

13 Recommendations for a cognitively active lifestyle (LaRue 2010)
Social interactions can be a great way to stimulate the mind.

14 Social Health The influence of social and environmental resources in finding a balance between capacities and limitations Domains Capacity of people to fulfil potential and obligations Ability to manage their life with some degree of independence despite a medical condition Ability to participate in social activities Huber et al. BMJ, 2011

15 Strongest predictors of how long you live
Social integration: how much you interact with people as you move through the date Close relationships Quit smoking Exercise Overweight Holt-Lunstad, Annual Review Psychology, 2018

16 Low social participation (RR: 1.41)
Less frequent social contact (RR: 1.57) Loneliness (RR: 1.58)

17

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