Improving Engagement of Mild to Moderate Dementia Alzheimer's Disease Patients Using Evidence-Based Visual Cognitive Stimulation Exercises

Dement Geriatr Cogn Disord. 2019;48(3-4):143-153. doi: 10.1159/000504799. Epub 2020 Jan 15.


Introduction: Different studies have proven the effectiveness of cognitive stimulation (CS) for people with mild to moderate dementia, but further research is needed to gain insight into how CS interventions should be designed and developed.

Objectives: The objective of this study was to gather and analyze data about the development of a series of CS sessions with Alzheimer's disease (AD) patients, to gain insight into how different individuals engage to different CS activities.

Methods: 24 AD patients with mild to moderate dementia (GDS = 4 and 5) participated in the study. Twelve different sessions were held with a different stimulation exercise each. Information about the achievement and engagement for each of the exercises were recorded for each patient.

Results: A significant correlation was found between the global engagement and the GDS level, and between engagement and gender (and also with educational level) for one of the exercises. These results may be useful for designing CS sessions depending on the composition of the group. For example, five exercises got very different engagement results when comparing patients with GDS = 4 and GDS = 5; if the session group consists of patients with both GDS levels, these kinds of exercises should be avoided to gain homogeneity in the engagement and prevent discouragement.

Conclusions: The type and characteristics of CS exercises have an impact on the engagement level of AD patients with mild to moderate dementia. Further studies are necessary to better understand which characteristics of the exercises affect the engagement of the patient according to their particularities. This kind of study may help the design of CS sessions and improve the results obtained.

Keywords: Alzheimer’s disease; Cognition disorders; Patient engagement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / rehabilitation*
  • Cognitive Behavioral Therapy / methods*
  • Educational Status
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Photic Stimulation / methods*
  • Recognition, Psychology
  • Sex Factors
  • Socioeconomic Factors