Cognitive and Psychosocial Effects of Individual Cognitive Stimulation in Dementia: A Randomized Controlled Trial

Abstract This study aimed to evaluate the impact of a year-long, home-based individual cognitive stimulation (iCS) program on cognitive performance, mood, functional independence, and quality of life (QoL) in older adults with mild Alzheimer’s disease and vascular dementia. Thirty-nine socially vulnerable, community-dwelling older adults with mild dementia (mean age = 79.7 ± 6.9 years; 66.7% female) were randomly assigned to an iCS group ( n = 18) or a control group ( n = 21) in a single-blind, parallel two-arm randomized controlled trial. The intervention group received 47 weekly iCS sessions delivered individually by trained professionals, while the control group continued their usual daily routines. Participants were assessed at baseline, midpoint (25 weeks), and post-intervention (50 weeks) using standardized measures. Outcomes included global cognitive function (Mini-Mental State Examination [MMSE], and Montreal Cognitive Assessment [MoCA]), mood (Geriatric Depression Scale-15), instrumental activities of daily living (adapted Lawton-Brody Index), and QoL (QoL-AD). The iCS group showed a significant improvement in global cognition, mood, and functional independence compared to the control group, which showed cognitive and emotional decline. The analysis of MMSE cognitive domains assessed revealed significant improvements in attention and calculation, and delayed recall; on the MoCA, there were improvements in attention, language, and delayed recall. Quality of life remained stable in the iCS group but declined in the control group, though without reaching statistical significance. Adherence, and degree of collaboration to the intervention were high. iCS delivered over an extended period appears to be a feasible and effective non-pharmacological intervention for preserving cognitive function, emotional well-being and autonomyin older adults with mild dementia. Trial registration Clinicaltrials.gov ID: NCT04417751; Care at 360º: A Long-term Individual Cognitive Stimulation Program.