A Quasi-experimental Study to Assess the Effectiveness of Cognitive Stimulation Therapy on Cognition among the Institutionalized Elderly in Selected Old Age Homes at Madurai

Abstract

Background of the Study: The aging population is increasing significantly in the world. Therefore,
world population is expected to be comprised of progressively bigger proportion of elderly
individuals. Human aging is an inevitable process and, as such, implies a process of transformation
and progressive change in biological, psychological and social structure. The cognitive function
begins to deteriorate with advancing age and there are common consequences to various
psychological and social aspects, such as the loss of significant people, employment, and entry into
the retirement, which can lead to isolation. Therefore, there is a risk of cognitive decline. Psychiatric
mental health nurse can play a vital role in reducing the adverse effects of aging such as decreased
memory, visuospatial skills, processing speed and executive functioning by cognitive stimulation.
Aim: The aim of the study was to assess the effectiveness of cognitive stimulation therapy on
cognition among the institutionalized elderly in old age homes. Methodology: Quasi-experimental
pre-test post-test control group design was used for the study. The study was conducted in selected
five old age homes in Madurai. A total of 150 elderly were selected using convenience-sampling
technique. Among 150, 75 were in the experimental group and 75 were in the control group. Tools
used were Mini-mental status examination, Test Your Memory Test (TYM test), clock drawing test,
digit symbol coding test and trial making test B. The cognitive stimulation therapy was administered
over 2 days in a week for 7 consecutive weeks. Data were analyzed using descriptive and inferential
statistics. Results: The cognitive stimulation therapy was effective in improving the memory (Pre-test
Vs Post-test I, F=2622.905, P<0.001), (Post-test I vs Post-test II comparison F=1460.149, P<0.001),

Visuospatial skills (Pre-test Vs Post-test I comparison F=422.891, P<0.001) and (post-test I vs post-
test II F=310.186, P<0.001), speed of processing (pre-test vs post-test I F=696.353, P<0.001), (Post-
test I vs post-test II F=425.315, P<0.001), and executive functioning (Pre-test vs Post-test I

F=593.568, P<0.001), (Post-test I Vs Post-test II F=373.078, P<0.001) of the institutionalized
elderly. There was a significant positive
relationship found between memory and
visuospatial skills, (r=0.845) memory and speed of
processing (r=0.758) and memory and executive
functioning (r=-0.860). There was a significant
association between memory and demographic
variables of the institutionalized elderly such as

education (Kruskal = 6.552, P<0.038) and co-
morbid illness (Kruskal = 9.902, P<0.042).

Conclusion: Population aging is a reality in the
world, becoming increasingly, a concern to be
given attention. And since to care for the elderly is
to value our history and future, we must create an
atmosphere and culture of cognitive stimulation to
maximize the older adult’s level of cognition. 

Engaging in cognitively stimulating activities in daily life will reduce the possibilities of cognitive
decline.