Effect of Comprehensive Non-Pharmacological Therapy in Patients with Cognitive Impairment and Dementia in Western Mexico

Abstract Background Non-pharmacological therapies (NPTs) are increasingly recognized as essential in dementia care, yet evidence from longitudinal, real-world cohorts in Latin America remains limited. Objective To evaluate cognitive trajectories associated with structured cognitive stimulation programs in institutionalized patients with dementia. Methods A retrospective observational study was conducted at Instituto Plenitud y Demencias A.C., Guadalajara, Mexico. Forty-six patients with dementia (mean age 77.3 years, 67.4% female) who had at least two comparable neuropsychological assessments between 2018 and 2024 were included. Cognitive domains were derived from MMSE, MoCA, NEUROPSI, and ENB, and scores were normalized to percentages (0–100). Domain change was classified as improvement ( > + 5%), deterioration (<–5%), or stable (–5% to + 5%). Pre–post comparisons were analyzed with the Wilcoxon signed-rank test, and effect sizes were calculated (r = Z/√N) with Holm–Bonferroni correction. Results Significant declines were observed in orientation (p = 0.0019, r = 0.56), encoding (p = 0.0012, r = 0.59), recall (p = 0.0325, r = 0.36), and executive functions (p = 0.0034, r = 0.56). Spatial integration significantly improved (p = 0.0170, r = 0.56). Attention showed a positive but non-significant trend, while language, motor sequential organization, and sensory integration remained stable. Conclusions In this institutional cohort, cognitive stimulation produced selective benefits, particularly enhancing spatial integration and stabilizing several functions, while declines in orientation, recall, encoding, and executive functions reflected disease progression. These findings highlight the potential of NPTs to preserve or improve specific domains in dementia, supporting their integration into long-term care strategies in Latin America.