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Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis

Personal Social Services Research Unit, London School of Economics; and Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London

LENE THORGRIMSEN, PhD

formerly Department of Mental Health Sciences, University College London

ANITA PATEL, MSc

Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London

AIMEE SPECTOR, PhD

Department of Mental Health Sciences, University College London

ANGELA HALLAM, MSc, Scottish Executive

Health and Community Care Research, Edinburgh (formerly Centre for the Economics of Mental Health, Institute of Psychiatry, King’s College London)

BOB WOODS, MSc

Dementia Services Development Centre, University of Bangor, Bangor

MARTIN ORRELL, PhD

Department of Mental Health Sciences, University College London, UK

Correspondence: Professor Martin Knapp, Personal Social Services Research Unit, London School of Economics, Houghton Street, London WC2A 2AE. Tel. +44 (0)20 7955 6225; email: m.knapp{at}lse.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Psychological therapy groups for people with dementia are widely used, but their cost-effectiveness has not been explored.

Aims To investigate the cost-effectiveness of an evidence-based cognitive stimulation therapy (CST) programme for people with dementia as part of a randomised controlled trial.

Method A total of 91 people with dementia, living in care homes or the community, received a CST group intervention twice weekly for 8 weeks; 70 participants with dementia received treatment as usual. Service use was recorded 8 weeks before and during the 8-week intervention and costs were calculated. A cost-effectiveness analysis was conducted with cognition as the primary outcome, and quality of life as the secondary outcome. Cost-effectiveness acceptability curves were plotted.

Results Cognitive stimulation therapy has benefits for cognition and quality of life in dementia, and costs were not different between the groups. Under reasonable assumptions, there is a high probability that CST is more cost-effective than treatment as usual, with regard to both outcome measures.

Conclusions Cognitive stimulation therapy for people with dementia has effectiveness advantages over, and may be more cost-effective than, treatment as usual.

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