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. 2023 Jan 31;2023(1):CD005562. doi: 10.1002/14651858.CD005562.pub3

Comparison 1. Cognitive stimulation versus no cognitive stimulation: post‐treatment.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Cognition 34 2340 Std. Mean Difference (IV, Random, 95% CI) 0.40 [0.25, 0.55]
1.1.1 ADAS‐Cog 21 1742 Std. Mean Difference (IV, Random, 95% CI) 0.30 [0.15, 0.46]
1.1.2 Global cognitive score (includes MMSE & CERAD) 1 56 Std. Mean Difference (IV, Random, 95% CI) 0.63 [0.09, 1.17]
1.1.3 MMSE 6 262 Std. Mean Difference (IV, Random, 95% CI) 0.52 [0.25, 0.79]
1.1.4 Mattis Dementia Rating Scale 1 101 Std. Mean Difference (IV, Random, 95% CI) 1.32 [0.89, 1.75]
1.1.5 Esame Neuropsicologico Breve 2 (ENB2) 1 20 Std. Mean Difference (IV, Random, 95% CI) 0.99 [0.05, 1.93]
1.1.6 Montreal Cognitive Assessment (MoCA) 2 76 Std. Mean Difference (IV, Random, 95% CI) 0.91 [0.22, 1.60]
1.1.7 ACE‐III 1 43 Std. Mean Difference (IV, Random, 95% CI) ‐0.28 [‐0.89, 0.33]
1.1.8 CAM‐COG‐DS 1 40 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.76, 0.48]
1.2 MMSE 25   Mean Difference (IV, Random, 95% CI) Subtotals only
1.2.1 One to twelve months of CS 25 1893 Mean Difference (IV, Random, 95% CI) 1.99 [1.24, 2.74]
1.2.2 24 months of CS 1 29 Mean Difference (IV, Random, 95% CI) 5.99 [‐1.58, 13.56]
1.3 ADAS‐Cog 21   Mean Difference (IV, Random, 95% CI) Subtotals only
1.3.1 One to 12 months of CS 21 1742 Mean Difference (IV, Random, 95% CI) 2.42 [1.21, 3.63]
1.3.2 24 months of CS 1 29 Mean Difference (IV, Random, 95% CI) 11.94 [‐0.97, 24.85]
1.4 Quality of Life: self‐report 18 1584 Std. Mean Difference (IV, Random, 95% CI) 0.25 [0.07, 0.42]
1.4.1 QoL‐AD 17 1541 Std. Mean Difference (IV, Random, 95% CI) 0.26 [0.07, 0.44]
1.4.2 EQ‐5D 1 43 Std. Mean Difference (IV, Random, 95% CI) 0.03 [‐0.58, 0.63]
1.5 Quality of Life: proxy‐rated 11 988 Std. Mean Difference (IV, Random, 95% CI) 0.21 [0.00, 0.42]
1.5.1 QoL‐AD proxy 10 963 Std. Mean Difference (IV, Random, 95% CI) 0.20 [‐0.02, 0.41]
1.5.2 QoL‐D 1 25 Std. Mean Difference (IV, Random, 95% CI) 0.52 [‐0.29, 1.34]
1.6 Communication and social interaction 7 702 Std. Mean Difference (IV, Random, 95% CI) 0.53 [0.36, 0.70]
1.6.1 Holden Communication Scale 3 299 Std. Mean Difference (IV, Random, 95% CI) 0.40 [0.15, 0.65]
1.6.2 Narrative language ‐ communicative abilities 2 259 Std. Mean Difference (IV, Random, 95% CI) 0.64 [0.38, 0.89]
1.6.3 NOSGER ‐ Social Behaviour 2 144 Std. Mean Difference (IV, Random, 95% CI) 0.71 [0.16, 1.26]
1.7 Mood: Self‐reported 10 787 Std. Mean Difference (IV, Random, 95% CI) 0.11 [‐0.08, 0.31]
1.7.1 Geriatric Depression Scale (GDS‐30) One to twelve months of CS 4 213 Std. Mean Difference (IV, Random, 95% CI) 0.28 [‐0.02, 0.58]
1.7.2 Geriatric Depression Scale (14 item) One to twelve months of CS 1 26 Std. Mean Difference (IV, Random, 95% CI) ‐0.39 [‐1.16, 0.39]
1.7.3 Geriatric Depression Scale (GDS‐15) One to twelve months of CS 2 402 Std. Mean Difference (IV, Random, 95% CI) 0.22 [‐0.43, 0.88]
1.7.4 HADS ‐ Depression 1 34 Std. Mean Difference (IV, Random, 95% CI) ‐0.34 [‐1.04, 0.37]
1.7.5 CESD‐R 1 60 Std. Mean Difference (IV, Random, 95% CI) 0.21 [‐0.31, 0.73]
1.7.6 Cornell Scale for Depression in Dementia (self‐report) 1 52 Std. Mean Difference (IV, Random, 95% CI) ‐0.02 [‐0.56, 0.52]
1.8 Anxiety: Interviewer/staff‐rated 6 410 Std. Mean Difference (IV, Random, 95% CI) 0.11 [‐0.09, 0.30]
1.8.1 Hamilton Anxiety Rating Scale 1 14 Std. Mean Difference (IV, Random, 95% CI) 0.84 [‐0.27, 1.95]
1.8.2 NPI ‐ anxiety subscale 1 39 Std. Mean Difference (IV, Random, 95% CI) ‐0.07 [‐0.69, 0.56]
1.8.3 Rating of Anxiety in Dementia (RAID) 4 357 Std. Mean Difference (IV, Random, 95% CI) 0.10 [‐0.11, 0.31]
1.9 Mood: Interviewer/staff‐rated 11 1011 Std. Mean Difference (IV, Random, 95% CI) 0.35 [0.09, 0.61]
1.9.1 Cornell Scale for Depression in Dementia 9 877 Std. Mean Difference (IV, Random, 95% CI) 0.36 [0.05, 0.67]
1.9.2 NOSGER ‐ Mood 1 119 Std. Mean Difference (IV, Random, 95% CI) 0.35 [‐0.02, 0.71]
1.9.3 Montgomery‐Asberg Depression Rating Scale 1 15 Std. Mean Difference (IV, Random, 95% CI) 0.31 [‐0.72, 1.33]
1.10 Quality of Relationship: self‐report 4 492 Std. Mean Difference (IV, Random, 95% CI) ‐0.01 [‐0.27, 0.25]
1.10.1 QCPR 3 455 Std. Mean Difference (IV, Random, 95% CI) 0.08 [‐0.15, 0.31]
1.10.2 Relationship Satisfaction Scale 1 37 Std. Mean Difference (IV, Random, 95% CI) ‐0.37 [‐1.03, 0.29]
1.11 ADL scales 7 360 Std. Mean Difference (IV, Random, 95% CI) 0.19 [‐0.03, 0.41]
1.11.1 Stewart ADL scale 1 23 Std. Mean Difference (IV, Random, 95% CI) 0.25 [‐0.57, 1.08]
1.11.2 Barthel ADL scale 3 249 Std. Mean Difference (IV, Random, 95% CI) 0.16 [‐0.11, 0.43]
1.11.3 Erlangen Test of ADL 1 61 Std. Mean Difference (IV, Random, 95% CI) 0.29 [‐0.21, 0.80]
1.11.4 Katz ADL scale 2 27 Std. Mean Difference (IV, Random, 95% CI) 0.12 [‐0.63, 0.88]
1.12 Instrumental ADL 13 1318 Std. Mean Difference (IV, Random, 95% CI) 0.15 [0.04, 0.26]
1.12.1 Lawton Brody Instrumental ADL 3 197 Std. Mean Difference (IV, Random, 95% CI) 0.17 [‐0.11, 0.45]
1.12.2 Disability Assessment for Dementia 2 179 Std. Mean Difference (IV, Random, 95% CI) 0.23 [‐0.07, 0.52]
1.12.3 NOSGER IADL subscale 1 119 Std. Mean Difference (IV, Random, 95% CI) 0.42 [0.06, 0.79]
1.12.4 Bristol Activities of Daily Living Scale (BADLS) 2 408 Std. Mean Difference (IV, Random, 95% CI) 0.05 [‐0.15, 0.24]
1.12.5 Alzheimer's Disease Cooperative Study ‐ ADL Scale 4 355 Std. Mean Difference (IV, Random, 95% CI) 0.10 [‐0.11, 0.31]
1.12.6 Rapid Disability Rating Scale 1 60 Std. Mean Difference (IV, Random, 95% CI) 0.33 [‐0.19, 0.85]
1.13 Behaviour that challenges 12 1340 Std. Mean Difference (IV, Random, 95% CI) 0.18 [‐0.01, 0.38]
1.13.1 NPI 8 1137 Std. Mean Difference (IV, Random, 95% CI) 0.13 [‐0.10, 0.36]
1.13.2 NPI ‐ Agitation 1 39 Std. Mean Difference (IV, Random, 95% CI) 0.00 [‐0.63, 0.63]
1.13.3 NOSGER ‐ Challenging Behaviour 1 119 Std. Mean Difference (IV, Random, 95% CI) 0.32 [‐0.04, 0.68]
1.13.4 Behave‐AD 1 20 Std. Mean Difference (IV, Random, 95% CI) 1.30 [0.32, 2.29]
1.13.5 Dementia Behaviour Disturbance Scale (DBD) 1 25 Std. Mean Difference (IV, Random, 95% CI) 0.19 [‐0.61, 0.99]
1.14 Behaviour, General Rating Scales 6 505 Std. Mean Difference (IV, Random, 95% CI) 0.35 [0.13, 0.58]
1.14.1 CAPE Behaviour Rating Scale 4 326 Std. Mean Difference (IV, Random, 95% CI) 0.21 [‐0.01, 0.43]
1.14.2 NOSGER 1 119 Std. Mean Difference (IV, Random, 95% CI) 0.65 [0.28, 1.02]
1.14.3 Blessed Dementia Rating Scale 1 60 Std. Mean Difference (IV, Random, 95% CI) 0.51 [‐0.02, 1.03]
1.15 Caregiver outcome ‐ anxiety 5 600 Std. Mean Difference (IV, Random, 95% CI) ‐0.00 [‐0.19, 0.19]
1.15.1 Hamilton Anxiety Scale 2 150 Std. Mean Difference (IV, Random, 95% CI) 0.18 [‐0.33, 0.68]
1.15.2 Hospital Anxiety & Depression Scale ‐ Anxiety 3 450 Std. Mean Difference (IV, Random, 95% CI) ‐0.06 [‐0.33, 0.21]
1.16 Caregiver outcome ‐ depressed mood 8 664 Std. Mean Difference (IV, Random, 95% CI) 0.05 [‐0.10, 0.21]
1.16.1 Hospital Anxiety & Depression Scales ‐ depression 4 490 Std. Mean Difference (IV, Random, 95% CI) 0.02 [‐0.16, 0.20]
1.16.2 Hamilton Depression Scale 1 137 Std. Mean Difference (IV, Random, 95% CI) 0.03 [‐0.30, 0.37]
1.16.3 Beck Depression Inventory 1 14 Std. Mean Difference (IV, Random, 95% CI) 1.04 [‐0.10, 2.18]
1.16.4 Montgomery‐Asberg Depression Rating Scale 1 13 Std. Mean Difference (IV, Random, 95% CI) 0.19 [‐0.91, 1.28]
1.16.5 General Health Questionnaire (GHQ‐12) 1 10 Std. Mean Difference (IV, Random, 95% CI) 0.94 [‐0.41, 2.29]
1.17 Caregiver outcome ‐ caregiving stress/burden (2) 6 288 Std. Mean Difference (IV, Random, 95% CI) 0.09 [‐0.14, 0.32]
1.17.1 Caregiver Burden Inventory 2 151 Std. Mean Difference (IV, Random, 95% CI) 0.12 [‐0.50, 0.75]
1.17.2 Relative's Stress Scale 1 10 Std. Mean Difference (IV, Random, 95% CI) 0.35 [‐0.91, 1.60]
1.17.3 Zarit Burden Inventory 2 87 Std. Mean Difference (IV, Random, 95% CI) 0.14 [‐0.28, 0.57]
1.17.4 Caregiver Burden Scale 1 40 Std. Mean Difference (IV, Random, 95% CI) 0.23 [‐0.40, 0.85]
1.18 Caregiver outcome ‐ caregiving stress/burden (1) 6 286 Std. Mean Difference (IV, Random, 95% CI) 0.09 [‐0.15, 0.32]
1.18.1 Caregiver Burden Inventory 2 151 Std. Mean Difference (IV, Random, 95% CI) 0.12 [‐0.50, 0.75]
1.18.2 Relative's Stress Scale 2 50 Std. Mean Difference (IV, Random, 95% CI) 0.19 [‐0.37, 0.75]
1.18.3 Zarit Burden Inventory 1 45 Std. Mean Difference (IV, Random, 95% CI) 0.12 [‐0.47, 0.70]
1.18.4 Caregiver Burden Scale 1 40 Std. Mean Difference (IV, Random, 95% CI) 0.23 [‐0.40, 0.85]
1.19 Caregiver outcome ‐ health‐related quality of life 5 651 Std. Mean Difference (IV, Random, 95% CI) 0.17 [‐0.14, 0.49]
1.19.1 EQ‐5D 4 514 Std. Mean Difference (IV, Random, 95% CI) 0.24 [‐0.18, 0.65]
1.19.2 SF‐36 1 137 Std. Mean Difference (IV, Random, 95% CI) ‐0.02 [‐0.35, 0.32]
1.20 Caregiver outcome ‐ SF‐12 3   Std. Mean Difference (IV, Random, 95% CI) Subtotals only
1.20.1 SF‐12 PCS 3 461 Std. Mean Difference (IV, Random, 95% CI) 0.07 [‐0.11, 0.25]
1.20.2 SF12 ‐ MCS 3 461 Std. Mean Difference (IV, Random, 95% CI) ‐0.05 [‐0.23, 0.13]
1.21 Caregiver outcome ‐ quality of relationship 3 367 Std. Mean Difference (IV, Random, 95% CI) 0.06 [‐0.26, 0.37]
1.21.1 QCPR 2 325 Std. Mean Difference (IV, Random, 95% CI) ‐0.07 [‐0.29, 0.15]
1.21.2 Relationship Satisfaction Scale 1 42 Std. Mean Difference (IV, Random, 95% CI) 0.53 [‐0.10, 1.15]
1.22 Caregiver outcome ‐ resilience 2 399 Std. Mean Difference (IV, Random, 95% CI) 0.06 [‐0.13, 0.26]
1.22.1 Brief Resilience Scale (Wagnild ‐ RS14) 1 356 Std. Mean Difference (IV, Random, 95% CI) 0.08 [‐0.13, 0.29]
1.22.2 Brief Resilience Scale (Smith and colleagues) 1 43 Std. Mean Difference (IV, Random, 95% CI) ‐0.07 [‐0.68, 0.53]