To improve quality of life for individuals with dementia, researchers have been investigating the use of cognitive and/or behavioral therapies to diminish related symptoms and improve overall functioning. A recent article published in the American Journal of Speech-Language Pathology reviews the current literature on cognitive interventions for individuals with dementia. The researchers found most interventions were deemed efficacious; however, several methodological limitations among the studies should be considered when interpreting their results.
The systematic review was conducted across 27 electronic databases, yielding a sample of 43 studies that fit the criteria for inclusion. Studies were organized by intervention technique and outcome measures, and were evaluated based on methodological quality. The outcomes of interest were cognitive-communication impairment and cognitive-communication activity limitations/participation restrictions. The intervention techniques were grouped into four primary categories and one “other” category: errorless learning (n = 14); spaced-retrieval training (n = 13); vanishing cues (n = 3) or verbal instruction/cuing (n = 11); and other (n = 8). Twenty-six studies measured cognitive-communication impairment and 21 studies measured activity limitations/participation restrictions. (Four studies overlapped, including both outcomes.) Although the results provide preliminary support for the use of the specific cognitive intervention techniques that were examined among all studies included in the review, additional testing is required because the majority of the studies were not experimental designs and only 10 percent of the studies reported treatment fidelity. Treatment fidelity is a key component to establishing internal validity and accurate replication of the intervention by other clinicians or researchers. Overall, the focus of most of the publications included in this review was about refining intervention variables (e.g., dosage) to yield optimal outcomes. Much research is needed prior to establishing any firm conclusions about which interventions yield the best results.
Hopper, T, Bourgeois, M, Pimentel, J, et al. An evidence-based systematic review on cognitive interventions for individuals with dementia. American Journal of Speech-Language Pathology (2013); 22, 126–145.