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Identifying prognostic indicators for cognitive stimulation therapy for dementia: Protocol for a systematic review and individual participant data meta-analysis

Lookup NU author(s): Professor Richard Walker, Dr Catherine DotchinORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.Background Cognitive stimulation therapy (CST) is the only non-pharmacological, treatment for dementia recommended by the UK National Institute for Health and Care Excellence, following multiple international trials demonstrating beneficial cognitive outcomes in people with mild-to-moderate dementia. However, there is limited understanding of whether treatment prognosis is influenced by sociodemographic and clinical variables (such as dementia subtype and gender), information which could inform clinical decision-making. Aim We describe the protocol for a systematic review and individual patient data meta-analysis assessing the prognostic factors related to CST. In publishing this protocol, we hope to increase the transparency of our work, and keep healthcare professionals aware of the latest evidence for effective CST. Method A systematic review will be conducted with searches of the bibliographic databases Medline, EMBASE and PsycINFO, from inception to 7 February 2023. Studies will be included if they are clinical trials of CST, use the Alzheimer's Disease Assessment Scale - Cognitive Subscale (gold-standard measure of cognition in dementia in clinical trials) and include participants with mild-to-moderate dementia. Following harmonisation of the data-set, mixed-effect models will be constructed to explore the relationship between the prognostic indicators and change scores post-treatment. Conclusions This is the first individual patient data meta-analyses on CST, and has the potential to significantly optimise patient care. Previous analyses suggest people with advanced dementia could benefit more from CST treatment. Given that CST is currently used post-diagnosis in people with mild-to-moderate dementia, the implications of confirming this finding, among identifying other prognostic indicators, are profound.

Publication metadata

Author(s): Crawley D, Saunders R, Buckman JEJ, Hui E, Walker R, Dotchin C, Spector A

Publication type: Article

Publication status: Published

Journal: BJPsych Open

Year: 2023

Volume: 9

Issue: 3

Print publication date: 01/05/2023

Online publication date: 17/04/2023

Acceptance date: 09/03/2023

Date deposited: 15/05/2023

ISSN (electronic): 2056-4724

Publisher: Cambridge University Press


DOI: 10.1192/bjo.2023.46


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