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JoaoLuis Alves Apostolo

JoaoLuis Alves Apostolo

Nursing School of Coimbra, Portugal

Title: The effectiveness of a cognitive stimulation therapy on elders cognition and depressive symptoms


Joao Luis Alves Apostolo has completed his PhD in Nursing Sciences at the age of 44 years from Oporto University and postdoctoral studies from Oporto University. He is Coordinator Professor at Nursing School of Coimbra andthe deputy director of The Portugal Centre for Evidence Based Practice: an Affiliate Centre of the Joanna Briggs Institute. He has published many papers in reputed journals and has been serving as an editorial board member of the Journal of Nursing "Referencia"


Purpose: This paper describes the effectiveness of a cognitive stimulation therapy (CST) on cognition and depressive symptoms in older adults in nursing homes (NH). Design: A randomized controlled trial, carried out from 2012 to 2013, included 56 residents from four NH, 36 women and 20 men (randomized into experimental and control groups). Eight participants dropped out. Methods: Participants of the experimental group underwent 14 CST sessions (7 weeks) in groups of 6 to 8 older adults and participants of the control group received usual care. The Montreal Cognitive Assessment, the Geriatric Depression Scale-15 and the Barthel Index of Activities of Daily Living (ADL) were administered at baseline and post-intervention. Findings: Repeated-measures revealed that CST increased cognition, (F=8.581; p=0.005) Partial Eta Squared = 0.157; power=0.82. There were no statistically significant differences in depressive symptoms (F=1.090; p=0.302). Baseline level of Activities of Daily Living did not affect the outcomes. Conclusion: CST had significantly improved cognition, explaining the 15.7% variability, but there was no statistical evidence of its effectiveness on depressive symptoms. This improvement was not affected by the baseline level of dependence/independence in ADL. Clinical Relevance: CST offers a range of activities, providing general stimulation for thinking, concentration, and memory usually in a social setting. These results will support implementation of CST in NH. In addition to the impact on elderly independence and autonomy, may also have an economic impact by reducing the direct costs of the impact of elders cognitive frailty.

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