A Pilot Study Investigating the Effectiveness, Appreciation, and Feasibility of a Cognitive Stimulation Program in Dementia Patients: Online versus Face-to-Face

Simona Cintoli ^1* Giulia Spadoni ¹ Valeria Giuliani ¹ Valentina Nicoletti ¹ Eleonora del prete ¹ Daniela Frosini ¹ Roberto Ceravolo ^1,2 Gloria Tognoni ¹

• ¹ Integrated Assistance Departments (D.A.I.) Neuroscience - Neurology Unit, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Tuscany, Italy
• ² Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Tuscany, Italy

Introduction. 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 well-being 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.Methods. The study involved 19 dementia patients (Clinical Dementia Rating = 1 or 2), with 12 undergoing in-person treatment and 7 participating remotely. Over eight weekly one-hour 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.Results. 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.Discussion. 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.