Benefit of Cognitive Stimulation Therapy in a Patient with Vascular Dementia: A Case Report

Authors

  • Billy Salvatore Soedirman Department of Neurology, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
  • Anak Agung Ayu Putri Laksmidewi Department of Neurology, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.5585

Keywords:

Vascular dementia, Cognitive stimulation therapy, AD-8, Coronavirus disease-19

Abstract

BACKGROUND: Cognitive stimulation therapy (CST) is a restoration therapy based on cognitive improvement of patients, by giving patients a variety of stimulation. This therapy is highly recommended for people with mild dementia from mild to moderate in either Alzheimer dementia or vascular dementia. Vascular dementia is a collection of symptoms of decreased cognitive abilities associated with the incidence of stroke.

CASE REPORT: Reported a 76-year-old man, who had a bleeding stroke, in admission the patient were often angry, sleepless, and aphasic. After returning home the patient experienced impairment in memory, language, executive ability, mild to moderate degree of visuospatial and incapable to manage his daily activities, therefore in routine evaluation of the 3rd month, patient was diagnosed as Vascular cognitive impairment. On regular home visits until the 6th month after the stroke, it was reported that in the first 6 months had been received CST. However, in the 7th–9th month of CST because at the time of the coronavirus disease-19 pandemic, human interaction was severely restricted, so patient monitoring was carried out using Ina AD-8 through phone. An evaluation of the cognitive function by measuring the cognitive function of the patient was using the Indonesian version of Montreal Cognitive Assessment (MoCA-Ina), as well as using activity daily living and instrumental daily living activities to measure the patient’s independence function. After 6 months of CST, there were cognitive improvements and were seen in MoCA – Ina, Ina AD-8 followed by improved patient independence.

CONCLUSION: Cognitive stimulation is the best intervention option in the treatment of mild to moderate vascular dementia. This case is one good example that shows the success of CST that has been observed for 9 months, not only on the cognitive component but also in terms of the ability to perform daily activities.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Smith EE. Clinical presentations and epidemiology of vascular dementia. Clin Sci. 2017;131(11):1059-68. https://doi.org/10.1042/CS20160607 PMid:28515342

Pendlebury ST, Mariz J, Bull L, Mehta Z, Rothwell PM. MoCA, ACE-R, and MMSE versus the national institute of neurological disorders and stroke-canadian stroke network vascular cognitive impairment harmonization standards neuropsychological battery after TIA and stroke. Stroke. 2011;43(2):464-9. https://doi.org/10.1161/strokeaha.111.633586 PMid:22156700

Henon H, Durieu I, Guerouaou D, Lebert F, Pasquier F, Leys D. Poststroke dementia: Incidence and relationship to prestroke cognitive decline. Neurology. 2001:57(7):1216-22. https://doi.org/10.1212/wnl.57.7.1216 PMid:11591838

Oldenbeuving AW, de Kort PL, Jansen BP, Algra A, Kappelle LJ, Roks G. Delirium in the acute phase after stroke: Incidence, risk factors, and outcome. Neurology. 201;76(11):993-9. https://doi.org/10.1212/WNL.0b013e318210411f PMid:21307355

Qu J, Chen Y, Luo G, Zhong H, Xiao W, Yin H. Delirium in the acute phase of ischemic stroke: Incidence, risk factors, and effects on functional outcome. J Stroke Cerebrovasc Dis. 2018;27(10):2641-47. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.05.034 PMid:30172676

McVeigh C, Passmore P. Vascular dementia: Prevention and treatment. Clin Interv Aging. 2006;1(3):229-35. https://doi.org/10.2147/ciia.2006.1.3.229 PMid:18046875

Ruitenberg A, Ott A, van Swieten JC, Hofman A, Breteler MM. Incidence of dementia: Does gender make a difference? Neurobiol Aging. 2001;22(4):575-80. https://doi.org/10.1016/ S0197-4580(01)00231-7 PMid:11445258

Planton M, Peiffer S, Albucher JF, Barbeau EJ, Tardy J, PastorJ, et al. Neuropsychological outcome after a first symptomatic ischaemic stroke with “good recovery.” Eur J Neurol. 2011;19(2):212-9. https://doi.org/10.1111/j.1468-1331.2011.03450.x PMid:21631652

Cooper S. The clinical assessment of the patient with early dementia. J Neurol Neurosurg Psychiatry. 2005;76(5):15-24. http://dx.doi.org/10.1136/jnnp.2005.081133 PMid:16291917

Toh HM, Ghazali SE, Subramaniam P. The acceptability and usefulness of cognitive stimulation therapy for older adults with dementia: A narrative review. Int J Alzheimers Dis. 2016;2016:5131570. https://doi.org/10.1155/2016/5131570 PMid:27478677

Woods B, Thorgrimsen L, Spector A, Royan L, Orrell M. Improved quality of life and cognitive stimulation therapy in dementia. Aging Ment Health. 2016;10(3):219-26. https://doi.org/10.1080/13607860500431652 PMid:16777649

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):2486-97. https://doi.org/10.1001/jama.285.19.2486 PMid:11368702

World Health Organization. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;34(1):62-9. https://doi.org/10.2337/dc11-S062 PMid:21193628

Ong PA, Muis A, Rambe S, Widjojo FS, Laksmidewi AA. Panduan Klinik: Diagnosis dan Penatalaksanaan Demensia. Indonesia: Perhimpunan Dokter Spesialis Saraf Indonesia; 2015. p. 23-50.

Freitag MH, Peila R, Masaki K, Petrovitch H, Ross GW, White LR, et al. Midlife pulse pressure and incidence of dementia: The Honolulu-Asia aging study. Stroke. 2006;37(1):33-7. https://doi.org/10.1161/01.STR.0000196941.58869.2d PMid:16339468

Emdin CA, Rothwell PM, Salimi-Khorshidi G, Kiran A, Conrad N, Callender T, et al. Blood pressure and risk of vascular dementia. Stroke. 2016;47(6):1429-35. https://doi.org/10.1161/STROKEAHA.116.012658 PMid:27165956

Hu GC, Chen YM. Post-stroke dementia: Epidemiology, mechanisms and management. Int J Gerontol. 2017;11(4):210-4. https://doi.org/10.1016/j.ijge.2017.07.004

Dichgans M, Leys D. Vascular cognitive impairment. Circ Res. 2017;120(3):573-91. https://doi.org/10.1161/CIRCRESAHA.116.308426 PMid:28154105

Henon H, Lebert F, Durieu I, Godefroy O, Lucas C, Pasquier F, et al. Confusional state in stroke: Relation to preexisting dementia, patient characteristics, and outcome. Stroke. 1999;30(4):773-9. https://doi.org/10.1161/01.STR.30.4.773 PMid:10187878

De J, Wand AP, Smerdely PI, Hunt GE. Validating the 4A’s test in screening for delirium in a culturally diverse geriatric inpatient population. Int J Geriatr Psychiatry. 2016;32(12):1322-9. https://doi.org/10.1002/gps.4615 PMid:27766672

Woods B, Aguirre E, Spector AE, Orrell M. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev. 2012;15(2):CD005562. https://doi.org/10.1002/14651858.CD005562.pub2 PMid:22336813

Aguirre E, Hoare Z, Streater A, Spector A, Woods B, Hoe J, et all. Cognitive stimulation therapy (CST) for people with dementiawho benefits most? Int J Geriatr Psychiatry. 2012;28(3):284-90. https://doi.org/10.1002/gps.3823 PMid:22573599

Streater A, Spector A, Aguirre E, Orrell M. Cognitive stimulation therapy (CST) for people with dementia in practice: An observational study. Br J Occup Ther. 2016;79(12):762-7. https://doi.org/10.1177/0308022616668358

Piras F, Carbone E, Faggian S, Salvalaio E, Gardini S, Borella E. Efficacy of cognitive stimulation therapy for older adults with vascular dementia. Dement Neuropsychol. 2017;11(4):434-41. https://doi.org/10.1590/1980-57642016dn11-040014 PMid:29354225

Galvin JE, Roe CM, Powlishta KK, Coat MA, Much SJ, Grant E. The AD8: A brief informant interview to detect dementia. Neurology. 2005;65(4):559-64. https://doi.org/10.1212/01.wnl.0000172958.95282.2a PMid:16116116

Tiel C, Sudo FK, Alves GS, Ericeira-Valente L, Moreira DM, Laks J, etal. Neuropsychiatric symptoms in vascular cognitive impairment: A systematic review. Dement Neuropsychol. 2015;9(3):230-6. https://doi.org/10.1590/1980-57642015dn93000004 PMid:29213966

Downloads

Published

2021-01-10

How to Cite

1.
Soedirman BS, Laksmidewi AAAP. Benefit of Cognitive Stimulation Therapy in a Patient with Vascular Dementia: A Case Report. Open Access Maced J Med Sci [Internet]. 2021 Jan. 10 [cited 2021 Sep. 20];9(C):10-4. Available from: https://oamjms.eu/index.php/mjms/article/view/5585

Issue

Section

Case Report in Internal Medicine

Categories

Most read articles by the same author(s)