Effectiveness of Cognitive-stimulating Activities on Patients with Alzheimer’s Disease

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterised by cognitive decline, memory loss and impaired daily functioning. Cognitive-stimulating activities (CSAs) have been proposed as a non-pharmacological intervention to enhance cognitive function in AD patients by promoting neuroplasticity and cognitive reserve. Aim: This study aimed to evaluate the effectiveness of CSA on cognitive function in AD patients and identify predictors of cognitive improvement. Setting and Design: A randomised controlled trial was conducted at Jawaharlal Nehru Medical College and Hospital, India, involving 200 AD patients (aged ≥60 years, Mini-Mental State Examination [MMSE] score <24). Participants were randomly assigned to either a CSA group ( n = 100) receiving guided storytelling sessions twice weekly or a standard care group ( n = 100). Methods: Cognitive function was assessed at baseline and post-intervention using the MMSE and AD Assessment Scale–Cognitive Subscale (ADAS-Cog). Regression analysis was performed to determine predictors of cognitive outcomes. Statistical Analysis Used: Independent t -tests, paired t -tests, Chi-square tests, multiple linear regression, analysis of covariance (ANCOVA) and binary logistic regression were employed. Results: The CSA group showed significant improvement in MMSE (baseline: 17.3 ± 3.6 vs. post-intervention: 20.4 ± 4.2, P < 0.001) and ADAS-Cog (25.4 ± 6.7 vs. 19.6 ± 5.3, P < 0.001) scores compared to the control group. Multiple linear regression identified CSA participation (β = 0.37, P < 0.001), higher education (β = 0.22, P < 0.001) and baseline cognitive scores (β = −0.56, P < 0.001) as significant predictors of final cognitive scores. ANCOVA revealed a significant interaction effect, demonstrating greater efficacy in patients with mild AD versus moderate AD ( P < 0.05 for both scales). Logistic regression indicated that CSA participation increased the odds of achieving a clinically significant improvement by nearly sevenfold (odds ratio = 6.82, 95% confidence interval [3.06, 15.22], P < 0.001). Conclusion: CSAs significantly enhance cognitive function in AD patients, with education and baseline cognition playing key predictive roles. Incorporating CSA into AD care may offer therapeutic benefits in slowing cognitive decline.