Cognitive Stimulation in Activities of Daily Living for individuals living with mild-to-moderate dementia (CS-ADL): a feasibility study

Background: Cognitive Stimulation in Activities of Daily Living (CS-ADL) is an occupational therapist-led group cognitive stimulation program for people living with mild-to-moderate dementia that aims to enhance functioning of activities of daily living (ADLs). This study investigated the feasibility of CS-ADL and a randomised controlled design comparing the effect of CS-ADL to treatment-as-usual (TAU) on ADL outcomes. Methods This feasibility study used a non-randomiseddesign. Recruitment took place primarily within healthcare settings and supplemented via community outreach, media and voluntary organisations. Due to recruitment challenges, randomisation was not possible and between-group comparisons were not appropriate. ADL functioning, cognition, communication, quality of life (QOL) and neuropsychiatric symptoms (NPS) were assessed at baseline and follow-up. Data were analysed using descriptive statistics. Results Sixteen participants were enrolled in the study, 12 of which completed follow-up assessments. Recruitment rates differed across intervention sites and affected the feasibility of study design. Thirteen participants were allocated to the intervention group (CS-ADL) and three were allocated to TAU. A reduction in caregiver distress from neuropsychiatric symptoms was observed in the intervention group at follow-up. No meaningful change at follow-up was identified in other secondary outcomes. Conclusions This is the first study to evaluate the feasibility of a trial comparing CS-ADL to TAU. Several challenges were identified in relation to recruitment, study design and outcome measures that require modification to enhance feasibility and rigour of future trials. Preliminary results indicate CS-ADL may reduce caregiver distress related to neuropsychiatric symptoms. Further research is necessary to confirm these findings.