Cognitive Therapy for Dementia Patients: A Systematic Review

Dement Geriatr Cogn Disord. 2018;46(1-2):1-26. doi: 10.1159/000490851. Epub 2018 Aug 9.


Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed.

Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia.

Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment.

Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found.

Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed.

Keywords: Alzheimer therapy; Cognitive therapy; Dementia; Reality orientation; Skills training; Systematic review.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Alzheimer Disease / psychology
  • Alzheimer Disease / therapy*
  • Cognition
  • Cognition Disorders / therapy
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Female
  • Humans
  • Language
  • Male
  • Randomized Controlled Trials as Topic
  • Reality Testing
  • Treatment Outcome