Cognitive stimulation (CS) is a nonpharmacological intervention often involving group activities and social interaction used to treat cognitive declines in people with dementia. This preregistered systematic review and meta-analysis evaluated the effectiveness of CS in producing benefits on cognition (primary outcome) and quality of life, activities of daily living, and psychological symptoms (secondary outcomes) across 44 randomized-controlled trials comprising 45 comparisons including 2,444 participants. A medium-sized effect (g = .49) on global cognition was found immediately after the intervention and was supported by decisive Bayesian evidence. Clinical relevance is defined as a reduction of 3 to 4 points on the Alzheimer's Disease Assessment Scale Cognitive subscale; the average attenuation of cognitive decline observed was 2.41 points (after removing 1 outlier). Therefore, the observed decline was of borderline clinical relevance. CS was also found to significantly improve memory, activities of daily living, depressive symptoms, and dementia ratings; most of these effects were supported by substantial and strong Bayesian evidence. No significant effects were found for global cognition at 1 to 10 months follow-up assessment for language, quality of life, anxiety, and behavior symptoms. However, evidence for the absence of these effects was ambiguous. A review of study bias highlighted that most studies lacked active, double-blinded controls, potentially leading to an overestimation of the effect, and making it difficult to conclusively attribute the observed improvements to the CS intervention. Hence, although effects are promising, the methodological issues highlight there is still a need for better controlled studies that provide more compelling evidence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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认知刺激对痴呆症的有效性：系统评价和荟萃分析。

认知刺激 (CS) 是一种非药物干预，通常涉及团体活动和社交互动，用于治疗痴呆症患者的认知能力下降。这项预先注册的系统评价和荟萃分析评估了 CS 在 44 项随机对照试验中对认知（主要结果）和生活质量、日常生活活动和心理症状（次要结果）产生益处的有效性，这些试验包括 45 项比较，其中 2,444参与者。干预后立即发现了对全球认知的中等影响 (g = .49)，并得到了决定性贝叶斯证据的支持。临床相关性定义为阿尔茨海默病评估量表认知分量表降低 3 至 4 分；观察到的认知衰退的平均衰减为 2。41 分（去除 1 个异常值后）。因此，观察到的下降具有临界临床相关性。还发现 CS 可以显着改善记忆力、日常生活活动、抑郁症状和痴呆症评级；大多数这些影响都得到了大量有力的贝叶斯证据的支持。在 1 到 10 个月的语言、生活质量、焦虑和行为症状的随访评估中，没有发现对整体认知的显着影响。然而，没有这些影响的证据是模棱两可的。对研究偏倚的审查强调，大多数研究缺乏主动的双盲对照，这可能导致对效果的高估，并且难以最终将观察到的改进归因于 CS 干预。因此，虽然效果是有希望的，方法论问题突出表明，仍然需要进行更好的对照研究，以提供更有说服力的证据。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。