Cintoli Simona, Spadoni Giulia, Giuliani Valeria, Nicoletti Valentina, Del Prete Eleonora, Frosini Daniela, Ceravolo Roberto, Tognoni Gloria
Neurology Unit, Integrated Assistance Departments (DAI) Neuroscience, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Front Psychol. 2025 Apr 7;16:1561157. doi: 10.3389/fpsyg.2025.1561157. eCollection 2025.
This study was conducted to assess the feasibility, effectiveness, and appreciation of a cognitive stimulation protocol for dementia patients, comparing in-person and remote interventions. Cognitive stimulation is a key non-pharmacological therapy that supports cognitive abilities and psychological wellbeing in dementia patients, also benefiting caregivers. The COVID-19 pandemic highlighted the need for remote therapeutic options, yet the effectiveness and applicability of these for frail dementia patients require validation. The study aimed to evaluate whether a cognitive stimulation protocol could be adapted for remote use, particularly for patients facing logistical challenges.
The study involved 19 dementia patients (Clinical Dementia Rating = 1 or 2), with 12 undergoing in-person treatment and seven participating remotely. Over eight weekly 1 h sessions, patients engaged in various cognitive activities, including memory, attention, and problem-solving exercises, guided by a clinical psychologist. Remote participants received an introduction to basic computer literacy. Assessments were conducted using the Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) at the start (T0) and end (T1) of the intervention. Additionally, satisfaction was measured with visual and Likert scales for both patients and caregivers.
No significant differences were found between the in-person and remote groups in terms of age, education, or gender. The cognitive profiles and ability to perform daily activities remained stable throughout the intervention. Both patients and caregivers reported high levels of satisfaction, with positive feedback on the utility, enjoyment, and engagement in the sessions. The program was also found to be effective in offering support and engaging caregivers, demonstrating that the protocol was both feasible and well-received.
These findings suggest that remote cognitive stimulation interventions are a viable and beneficial alternative to in-person therapy. The high levels of satisfaction and stable cognitive outcomes are in line with previous studies. Future research with a larger sample size and long-term follow-up is needed to further assess the lasting impact on cognitive function, quality of life, and caregiver burden. The integration of remote protocols into healthcare systems could enhance access to therapy for a broader patient population.
本研究旨在评估针对痴呆症患者的认知刺激方案的可行性、有效性和接受度，比较面对面干预和远程干预。认知刺激是一种关键的非药物疗法，可支持痴呆症患者的认知能力和心理健康，对护理人员也有益处。2019年冠状病毒病疫情凸显了对远程治疗方案的需求，但这些方案对体弱的痴呆症患者的有效性和适用性需要验证。该研究旨在评估认知刺激方案是否可以改编用于远程使用，特别是对于面临后勤挑战的患者。
该研究涉及19名痴呆症患者（临床痴呆评定量表=1或2），其中12人接受面对面治疗，7人远程参与。在为期八周的每周1小时课程中，患者在临床心理学家的指导下参与各种认知活动，包括记忆、注意力和解决问题练习。远程参与者接受了基本计算机知识的介绍。在干预开始时（T0）和结束时（T1）使用简易精神状态检查表（MMSE）、日常生活活动（ADL）和工具性日常生活活动（IADL）进行评估。此外，使用视觉量表和李克特量表对患者和护理人员的满意度进行了测量。
面对面组和远程组在年龄、教育程度或性别方面没有发现显著差异。在整个干预过程中，认知状况和进行日常活动的能力保持稳定。患者和护理人员均报告了较高的满意度，对课程的实用性、趣味性和参与度给予了积极反馈。该方案还被发现有效地为护理人员提供了支持并让他们参与其中，表明该方案既可行又受到好评。
这些发现表明，远程认知刺激干预是面对面治疗的一种可行且有益的替代方案。高满意度和稳定的认知结果与先前的研究一致。需要进行更大样本量和长期随访的未来研究，以进一步评估对认知功能、生活质量和护理人员负担的长期影响。将远程方案整合到医疗保健系统中可以增加更广泛患者群体获得治疗的机会。
