Cognitive stimulation, training, and rehabilitation

Abstract

Cognition-focused interventions for people with cognitive impairment including mild-to-moderate dementia may be classified into three categories: cognitive stimulation, training, and rehabilitation. Cognitive stimulation, consisting of nonspecific cognition-enhancing activities often in group format, produces small improvements on some aspects of cognitive ability which can be accompanied by gains in quality of life, everyday functioning, and social interaction. Cognitive training which involves repeated practice of tasks that target specific cognitive functions, often using computers, provides improvements on trained tasks that usually do not translate to nontrained tasks and have little impact on real life. Cognitive rehabilitation represents an individual approach that focuses on disability rather than cognition per se and is helpful in terms of reaching personally relevant goals and improving day-to-day performance. Data are largely lacking to support commercial claims regarding the efficacy of video games or virtual reality and augmented reality devices. There is insufficient evidence from randomized controlled trials whether cognition-focused interventions can delay or prevent cognitive decline. However, data from prospective cohort studies strongly suggest that late-life cognitive activity is associated with a reduced risk of dementia.