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- I can't imagine how cognitive stimulation is changing the lives of people with dementia
I can't imagine how cognitive stimulation is changing the lives of people with dementia
In Moscow, specialists from the Scientific and Practical Gerontopsychiatric Center (NPGTS), together with MGPPU, are testing a new non-drug method for combating dementia — cognitive stimulating therapy (CTT). The program, developed in the UK in the late 1990s and early 2000s, is now used in dozens of countries, and its effectiveness has been confirmed by clinical studies. Russian scientists have adapted the methodology to the Russian cultural context and are testing its capabilities in practice. Izvestia found out how CTT works, how much it helps slow down cognitive decline, and whether it can be used in other formats in the future.
What is the special feature of cognitive-stimulating therapy?
When cognitive abilities decrease, a person is most often offered exercises for memory, attention and thinking. However, this approach mainly helps to improve precisely those skills that were directly trained and almost do not lead to changes in other areas or in everyday life.
The CST works differently. As noted by Armina Sargsyan, a medical psychologist at the NPGTS, during classes, memory, attention, speech and the ability to make decisions are simultaneously involved, while cognitive load is constantly combined with communication. Participants discuss different topics, recall events, formulate their own opinions, listen to each other and react to the statements of their interlocutors.
— KST is not just a set of exercises. In a safe and value-free environment, a person can share life stories, discuss topics, joke, argue, and form new associations. At the same time, he is not asked.: "Why don't you remember?", but they refer to preserved abilities: "What do you think about it?" — says Armina Sargsyan.
According to her, this format allows you to support not only individual functions, but also initiative, speech, social interaction and the ability to participate in everyday life. Emotional engagement plays an important role in the program. Therefore, classes are held in a group and are built around individual topics, rather than an individual set of tests. The course is designed for 14 meetings lasting 45-60 minutes.
— We see improvements in memory and attention among the participants, although it is premature to talk about sustainable results. For us, an equally important indicator is the desire of people to continue studying after completing the course," says Sargsyan.
At the same time, the methodology must be adapted to the conditions in which it is conducted. It is especially important for NPGTS specialists that the KST can be implemented in a hospital, taking into account the health and mobility of residents, their daily routine, the specifics of interaction with staff, and other factors. This approach allows you to make group classes a part of daily care, rather than a separate procedure.
How the KST is being implemented in Russia
After the effectiveness of cognitive-stimulating therapy was confirmed by foreign studies, Russian specialists began to adapt the program for the domestic system of care for the elderly. The MSPPU began this work in 2019, and in 2021-2024 the program underwent cultural adaptation and testing in cooperation with one of the Moscow houses of social services.
Adaptation did not just mean the translation of methodological materials. The specialists needed to check to what extent the content of the classes was understandable and interesting to the Russian participants, which topics evoked a response, and which elements required changes. The program includes songs, games, literary characters and discussion topics familiar to the older generation.
— It was fundamentally important for the team of specialists to go through the full path of cultural adaptation of the method. Psychologists, medical and social workers, as well as elderly people took part in this work — it was their feedback that helped us understand how the program corresponds to the Russian context," Anna Shvedovskaya, Deputy head of research at the Scientific and Practical Center for Gerontopsychology at MGPPU, told Izvestia.
The trial application of the method in Russia has shown that it can be used in the domestic system of assistance to people with cognitive impairments. The participants showed a steady interest in the classes and actively interacted within the group, and the staff of the institution noted an increase in social activity. At the same time, experts emphasize that additional observations are needed to assess the long-term effect.
The next stage was the creation of an infrastructure for the dissemination of the method. In 2024, MGPPU released the Russian-language manual "Changes for the Better", and in 2025, the university began to train specialists to work with the CST. The course is intended for psychologists, doctors, social workers and educators.
Now the program goes beyond individual tests. Specialists can complete theoretical training, practical internship and receive further methodological and supervisory support. At the beginning of 2026, the KST professional club began operating on the basis of MGPPU.
In parallel, the method is being tested in the context of daily care for the elderly. From February to April 2026, MGPPU specialists conducted a full cycle of CST for several groups living in the Moscow institution. According to preliminary observations, the participants regularly attended classes, were actively involved in the work and wanted to continue them after completing the course. However, experts have not yet drawn conclusions about the long-term effect.
Practical experience shows that when implementing the method, not only the program itself is important, but also the correct organization of groups. According to Armina Sargsyan, the Moscow Scientific and Practical Gerontopsychiatric Center began to implement the method in partnership with MGPPU in 2026. From February to April, a full CST cycle was conducted here for several groups of residents: two groups have already completed classes, and four more are continuing the program.
— When forming groups, the age, degree of cognitive impairment and level of education of the participants are taken into account. This allows us to make classes more suitable for specific people and support their active participation in the work of the group," notes Armina Sargsyan.
How effective is the CST
The method was developed as a non-drug aid for people with dementia, so its effectiveness was assessed not only by performing exercises, but also by changes in cognitive performance, quality of life, and daily functioning.
The first major results appeared in the early 2000s. In a randomized study published in 2003 in The British Journal of Psychiatry, program participants showed improvements on the MMSE and ADAS-Cog tests, as well as on the quality of life scale. The authors noted that the results are comparable to the effects observed in drug therapy trials for dementia.
Since then, the evidence base of the method has expanded. In the largest Cochrane review to date, 37 randomized trials involving 2,766 people with mild to moderate dementia were analyzed. The researchers found a small but statistically significant improvement in cognitive function after a course of stimulation. Participants also showed improvements in communication and social interaction, and to a lesser extent, in quality of life, mood, and some daily skills.
Anna Shvedovskaya estimates the average effect of CST as about a six-month delay in the expected cognitive decline. This does not mean stopping or curing dementia.
— With a progressive disease, six months of preserved functioning are by no means symbolic. For a person with dementia, this can mean additional time, during which they retain the ability to maintain a conversation, take the initiative, participate in their usual activities and make everyday decisions," notes Shvedovskaya.
At the same time, the effect of CST is not limited to test results. According to Armina Sargsyan, in their practical work, specialists also pay attention to how the behavior of participants changes during classes.
— We see improvements in memory and attention among our participants, although it is premature to talk about sustainable results. Another important indicator for us is the desire of people to continue studying after completing the course. This means that classes are becoming a significant part of their daily lives," Sargsyan notes.
NPGTS became one of the first practical platforms where KST began to be introduced into the system of comprehensive care for people with dementia. The center's specialists are trained, conduct courses for residents and gain practical experience in applying the program. The MGPPU provides methodological support in this cooperation.
At the same time, CTT is not considered as an independent method of treating dementia. The syndrome itself can be caused by various diseases, so helping a person requires an integrated approach. It can include early diagnosis, treatment of reversible causes of cognitive decline, control of vascular risk factors, drug therapy according to indications, physical activity, cognitive rehabilitation, adaptation of the household environment and family support.
— CST does not replace medical supervision and other types of care. This is one of the comprehensive support tools that allows you to work not only with individual functions, but also with a person's activity, independence and quality of life," emphasizes Armina Sargsyan.
How will the new method evolve?
At the next stage, it is important for scientists to understand how to adapt the method to different conditions and life circumstances so that cognitive support is available to more people.
Remote and digital formats can become one of the promising areas. They can expand access to classes for people with reduced mobility and residents of small towns where there are no specialists in cognitive rehabilitation. At the same time, the digital version should not be a simple transfer of exercises to the screen. Specialists will have to check whether the mechanisms of group interaction and emotional involvement, on which the classical program is based, are preserved in the remote format.
Potentially, CTT can be used at earlier stages of cognitive changes. Then the task will be not only to support already impaired functions, but also to find opportunities for early intervention. However, it is important to determine who really needs such a program and when: memory complaints in themselves do not mean dementia, and the causes of cognitive impairment can be different.
The development of the method is also related to the training of specialists. According to Anna Shvedovskaya, in the future, CTT should become part of interdisciplinary care involving clinical psychologists, neuropsychologists, doctors, social workers, educational psychologists and rehabilitation specialists. This requires not only courses, but also practical training, supervision, and evaluation of results.
Dementia has different causes and manifestations, so a person may simultaneously need medical supervision, correction of risk factors, physical activity, family support and a change in the household environment. Cognitive stimulation in this system can become one of the tools that help to stay active and independent for longer.
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