Summary of findings 2. Group cognitive stimulation compared to no cognitive stimulation (post‐treatment) in people with dementia.
| Group cognitive stimulation compared to no cognitive stimulation (post‐treatment) in people with dementia | ||||||
| Patient or population: people with dementia Setting: care homes and long‐term care facilities; community settings including daycare and outpatients Intervention: group cognitive stimulation Comparison: no cognitive stimulation (post‐treatment) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with no cognitive stimulation (post‐treatment) | Risk with group cognitive stimulation | |||||
| Cognition Assessed with various brief cognitive tests including: ADAS‐Cog, MMSE, Global Cognitive Score; Mattis Dementia Rating Scale, MoCA, ENB2 | SMD 0.43 SD higher (0.26 higher to 0.59 higher) | ‐ | 1637 (27 RCTs) | ⊕⊕⊕⊝ Moderate a | Group cognitive stimulation probably results in a small increase in cognition. | |
| Quality of Life: self‐report Assessed with: QoL‐AD | SMD 0.28 SD higher (0.05 higher to 0.52 higher) | ‐ | 1058 (13 RCTs) | ⊕⊕⊝⊝ Low bc | Group cognitive stimulation may result in a slight increase in self‐reported quality of life. | |
| Communication and social interaction Assessed with: Holden Communication Scale; NOSGER‐Social Behaviour subscale; Narrative language ‐ communicative abilities | SMD 0.53 SD higher (0.36 higher to 0.7 higher) | ‐ | 702 (7 RCTs) | ⊕⊕⊕⊕ High | Group cognitive stimulation results in an increase in communication and social interaction. | |
| Mood: self‐reported assessed with: Geriatric Depression Scale (14 and 30‐item versions); CESD‐R | SMD 0.2 SD higher (0.06 lower to 0.45 higher) | ‐ | 299 (6 RCTs) | ⊕⊕⊕⊝ Moderate d | Group cognitive stimulation probably results in a slight improvement in self‐reported mood. | |
| Mood: interviewer/staff‐rated Assessed with: Cornell Scale for Depression in Dementia; NOSGER‐Mood subscale; Montgomery‐Asberg Depression Rating Scale | SMD 0.4 SD higher (0.14 higher to 0.67 higher) | ‐ | 959 (10 RCTs) | ⊕⊕⊕⊝ Moderate b | Group cognitive stimulation probably results in a small improvement in interviewer/staff‐rated mood. | |
| Instrumental ADL Assessed with: Lawton‐Brody IADL scale; Disability Assessment for Dementia; NOSGER IADL subscale; ADCS‐ADL scale; Rapid Disability Rating Scale | SMD 0.2 SD higher (0.05 higher to 0.35 higher) | ‐ | 687 (8 RCTs) | ⊕⊕⊕⊕ High | Group cognitive stimulation results in a slight increase in Instrumental ADL. | |
| Behaviour that challenges assessed with: NPI; NPI‐Agitation subscale; NOSGER‐Challenging Behaviour subscale; BEHAVE‐AD; Dementia Behaviour Disturbance subscale | SMD 0.33 SD higher (0.11 higher to 0.54 higher) | ‐ | 754 (8 RCTs) | ⊕⊕⊕⊝ Moderate a | Group cognitive stimulation probably results in a slight improvement in behaviour that challenges. | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ADL: activities of daily living; CI: confidence interval; OR: odds ratio; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
a Downgraded one point for inconsistency as moderate heterogeneity was present.
b Downgraded one point for inconsistency as substantial heterogeneity was present.
c Downgraded one point for imprecision as 95% CIs included both a clinically important and a negligible effect.
d Downgraded one point for imprecision as fewer than 400 participants.