About Cognitive Stimulation Therapy

Cognitive Stimulation Therapy (CST) reduces symptoms of mild cognitive impairment (MCI) and early to mid-stage dementia. Read more below to get your questions answered.
forBetterMinds provides CST both in-person or virtually, so that you can receive benefits of Cognitive Stimulation Therapy in the comfort of your own home, wherever you live.

What is cognitive stimulation therapy (CST)?

Cognitive stimulation therapy (CST) is a non-pharmacological intervention developed to improve cognition of people living with mild cognitive impairment (MCI) and early to mid-stage dementia, including Alzheimer’s Disease.  CST was designed in the United Kingdom by Dr. Aimee Spector and several dementia experts following an extensive evaluation of research evidence.

Although early studies were focused on improvements in cognition, including recall, word-finding and verbal comprehension, results of the program have also shown improvements in quality of life, depression, and reduction in behavioral and psychological symptoms of dementia [1].

Used in over 30 countries, cognitive stimulation therapy (CST) is a scientifically proven conversation-based dementia treatment that exercises the mind and improves cognition, memory, language skills, confidence, and quality of life. Although CST was created to help people living with mild cognitive impairment (MCI) and early to mid-stage dementia, the program has also been shown to improve cognition of people with normal age-related cognitive decline.

How does CST work?

CST increases neural networks and connections in the brain.  In a research trial whereby CST participants had brain imaging taken before and after the program, several areas of the brain responsible for memory and language were more active or “upregulated” after the program [1, 2]. CST studies show that it is possible to increase the capability of the healthy neurons that remain during cognitive decline.

The brain, with or without dementia, is capable of changing in both structure and function. Numerous studies have shown that our brains are capable of adding new neurons to increase grey matter and white matter (through physical exercise) and change activity and function of certain areas of the brain by cognitive stimulation and learning new things.   CST studies show that even during brain atrophy (dying off of nerve cells during the course of dementia) it is possible to increase the capability of the remaining neurons.

Wondering if your loved one would be interested in CST?

What happens during cognitive stimulation therapy?

Our program runs for 7 weeks, and we meet 2x per week (14 sessions in all). At each session, a forBetterMinds Coach will guide the participant(s) through conversations to help generate thoughts and opinions on material that is customized for the level of ability, as well as the particular interests, of the participant. Material can range from the latest news and events, sports, current affairs, food, games, and the participant’s favourite music – and will be especially curated for each session.

Coaches guide the conversation so that there’s no right or wrong answer, and there’s no testing whatsoever. Participant’s minds will be exercised, and these exercises will help strengthen neural connections in their brain. 

Sessions can be delivered in several formats.  When in-person, CST can be delivered to small groups or one-on-one. Sessions can also be held virtually by using teleconferencing software such as Zoom. Virtual cognitive stimulation therapy (vCST) can be delivered in group format or individual one-on-one format.  

What are the benefits of cognitive stimulation therapy?

In terms of formal tests and assessments, people who have completed a program of CST have shown significant improvement in the various cognitive tests including the Mini-Mental State Examination (MMSE), the Alzheimer’s Disease Assessment Scale, cognitive subsection (ADAS-cog), and the behavioral and psychological symptoms of dementia (BPSD) scores [1].

In layman’s terms, the benefits of CST have been observed as follows:

  1. Improved recall and episodic memory,
  2. Improved auditory comprehension – understanding what people are saying,
  3. Increased confidence, taking part in conversation more,
  4. Feelings of personhood, remembering who you are, and better recalling of childhood and autobiographical information,
  5. Higher quality of life, less depressive emotions, feeling optimistic, and
  6. Some studies have shown an improvement in executive function after completion of a CST program.

 

The Quality of Life-Alzheimer’s Disease (QoL-AD) scale allows people to self-assess their mood, memory, relationships, level of participation in fun activities, and independence. When quality of life has been assessed before and after completion of a CST program, participants reported increased scores after CST. Not only are quality of life scores higher for participants after a CST program, but family caregivers also score higher after their loved ones complete a program.

What is the difference between cognitive training and cognitive stimulation therapy (CST)?

Cognitive training, or brain training, is based on completing repetitive tasks such as pattern detection to increase thinking or processing speed.  Today, brain training is often delivered through a computer or phone app and requires the participant to work their way through a video game.

Cognitive stimulation therapy, however, is not based on repetitive tasks, but instead on asking people their opinions on presented topics in order to generate new thoughts and ideas. Although there are cognitive stimulation therapy phone apps, CST is most often delivered by a human in an interactive and supportive environment. For those who are seeking human interaction, CST may be the preferred option for improving cognition.

What are the key principles of cognitive stimulation therapy?

The key principles of cognitive stimulation therapy are:

  • mental stimulation,
  • developing new ideas, thoughts, and associations,
  • focusing on opinions, rather than facts,
  • stimulating learning and communication,
  • stimulating language and discussion,
  • and maximizing potential [3].

Is CST evidence-based?

Yes, cognitive stimulation therapy has been researched and trialled for over 20 years. The benefits of CST have been documented in numerous scientific papers, some referenced below this article.

How long is a CST program ?

A cognitive stimulation therapy program usually consists of 14 sessions (about 45-50 minutes long), held twice per week for seven weeks.

How do I get started?

Fill in our contact form, and we will get back to you within 1 business day.
Our initial program is 14 sessions (7 weeks, 2 sessions per week). To make it easy for you to try it out, we currently offer an introductory session. The introductory session will be applied to the full program if you wish to continue.
What does Cognitive stimulation therapy do?
What does cognitive stimulation therapy do?
Dementia therapy Toronto
References
  1. Behfar Q, Richter N, Kural M, Clemens A, Behfar SK, Folkerts AK, Fassbender R, Kalbe E, Fink GR, Onur OA. Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease. Front Aging Neurosci. 2023 Aug 17;15:1140975. doi: 10.3389/fnagi.2023.1140975. PMID: 37662551; PMCID: PMC10470843.
  2. Liu, T.; Spector, A.; Mograbi, D.C.; Cheung, G.; Wong, G.H.Y. Changes in Default Mode Network Connectivity in Resting-State fMRI in People with Mild Dementia Receiving Cognitive Stimulation Therapy. Brain Sci.202111, 1137. https://doi.org/10.3390/brainsci11091137
  3. Yates, L.A., Yates, J., Orrell, M., Spector, A., & Woods, B. (Eds.). (2017). Cognitive Stimulation Therapy for Dementia: History, Evolution and Internationalism (1st ed.). Routledge. https://doi.org/10.4324/9781315209043