Table 1.

The Structured Cognitive Intervention Pathway.

Mini Mental State Examination Score	Clinical Dementia Rating Stage	Global Deterioration Scale Level	Common symptoms	Intervention options	Stage Specific Intervention Group
30–27	0: No cognitive impairment	1: No cognitive decline	None	Cognitive reserve maintenance	Cognitive reserve maintenance
27–24	0.5: Questionable or very mild dementia	2: Very mild cognitive decline			Cognitive stimulation therapy Reality orientation
					Reminiscence therapy
24–20	1: Mild	2: Very mild cognitive decline	Forgetting time and place	Cognitive stimulation therapy	Cognitive stimulation therapy
			Forgetting recent events	Reality orientation	Talking therapy
			Forgetting daily tasks, money, bathing, eating	Reminiscence therapy	Reminiscence therapy
			Signs of depression	Talking therapy
			Difficulty in communicating thoughts
			Difficulty in finding and explaining words
		3: Mild cognitive decline	Difficulty in forming sentences		Talking therapy
			Simple problem solving		Reality orientation
			Familiar task completion – ADL's		Reminiscence therapy
			Unable to plan and complete tasks
20–13	2: Moderate	4: Moderate cognitive decline	Signs of depression		Music Therapy
			Personality shift affecting judgement		Art Therapy
			Withdrawn and reduced communication		Smell Therapy
			Sleeping pattern changes	Music Therapy	Bright Light Therapy
				Art Therapy
	2: Moderate	5: Moderately severe cognitive decline	Hallucinations	Smell Therapy	Touch Therapy
			Disorientation / confusion	Touch Therapy	Smell Therapy
			Wandering	Food Therapy	Food Therapy
			Behavioural symptoms of distress	Reminiscence Therapy	Reminiscence Therapy
				Validation Therapy
	2: Moderate	6: Severe cognitive decline	Unable to recognise family	Bright Light Therapy	Validation Therapy
			Unable to recognise precious memories		Music Therapy
			Inability to dress or odd dress habits		Smell Therapy
			Behavioural symptoms of distress		Bright Light Therapy
			Change in sleeping patterns
Less than 13	3: Severe	7: Very severe cognitive decline	Increased falls	Music Therapy	Music Therapy
			Repetitive behaviours	Physical Therapy	Physical Therapy
			Involuntary movements	Touch Therapy	Touch Therapy
			Inability to manage self-care
			Full time care required
			Full loss of neurological function
			Death

The full list of references for the interventions listed in the table are beyond the reference allowance for this paper but are available on request.