Individual cognitive stimulation therapy (iCST) for people with intellectual disability and dementia: a feasibility randomised controlled trial

• Published in: Aging & mental health 2022-04, Vol.26 (4), p.698-708
• Main Authors: Ali, Afia, Brown, Emma, Tsang, Winnie, Spector, Aimee, Aguirre, Elisa, Hoare, Sarah, Hassiotis, Angela
• Format: Article
• Language: English
• Subjects: Acceptability; Accuracy; Adaptive behavior; Adaptive control; Caregivers; Cognition; Cognitive stimulation; Cognitive Stimulation Therapy; Dementia; Dementia - psychology; Dementia - therapy; Dementia disorders; Down Syndrome; Dyads; Feasibility; Feasibility Studies; feasibility study; Fidelity; Health services; Humans; Intellectual disabilities; Intellectual Disability - therapy; Intellectually disabled people; Intervention; Learning disabled people; Measures; Quality of Life; Recruitment; State Medicine; Stimulation; Stimuli; Trusts
• ISSN: 1360-7863; 1364-6915
• DOI: 10.1080/13607863.2020.1869180

To examine the feasibility, acceptability and fidelity of individual Cognitive Stimulation Therapy (iCST) in people with intellectual disability (ID) and dementia. We aimed to recruit forty dyads (carer and individual with dementia and ID) who were randomised to iCST or a waiting list control group. Both groups received treatment as usual. Family and paid carers delivered the manualised intervention (40 sessions over 20 weeks). Recruitment and retention of participants, intervention adherence, fidelity and acceptability were assessed. Outcome measures of cognition, adaptive functioning, quality of life (QoL) and carer outcomes were collected at baseline, midpoint (11 weeks) and at 21 weeks. Qualitative interviews were conducted with six carers about their experience of iCST. Forty dyads were recruited over 10 months from 12 National Health Service trusts. One dyad dropped out and 87.5% and 97.5% completed the midpoint and end-point assessments respectively. Assessment of fidelity indicated that the correct session structure was not followed; 70% completed at least 20 sessions and there was a high level of satisfaction with iCST. QoL was significantly higher in the iCST arm at 21 weeks (adjusted mean difference: 3.11; 95% CI: 0.64 to 5.58). There were no differences in the other outcome measures. The intervention was feasible and acceptable. A full-scale trial is warranted but some modifications are needed, including improved training and supervision for carers to improve fidelity.