Cognitive Stimulation and Training in People with Mild-to-Moderate Alzheimer’s Disease: A Scoping Review

Abstract

Highlights What are the main findings? The included studies showed short-term, outcome-specific patterns across structured cognitive stimulation and training interventions. Technology-assisted and conventional cognitive training primarily showed signals in cognitive outcomes, whereas reminiscence-based interventions more consistently reported changes in depressive and neuropsychiatric symptoms. What are the implications of the main findings? Cognitive stimulation and training may complement comprehensive, person-centred care, but current evidence is insufficient to establish comparative effectiveness or long-term benefits. Larger studies with standardized outcomes, replicable interventions, and longer follow-up are needed, including evaluation of maintenance or booster strategies. Abstract Background/Objectives: Cognitive stimulation and cognitive training are used as non-pharmacological approaches to support people living with Alzheimer’s disease, but Alzheimer-specific evidence is dispersed across heterogeneous intervention formats. This scoping review mapped structured cognitive stimulation and training interventions evaluated in people with mild-to-moderate Alzheimer’s disease and summarized the cognitive, emotional, functional, and follow-up outcomes reported. Methods: The review was conducted using the Joanna Briggs Institute methodology and reported according to PRISMA-ScR. PubMed, SciELO, PEDro, LILACS, and Google Scholar were searched on 24 February 2025 for studies published between January 2015 and 24 February 2025 in English, Portuguese, or Spanish. Intervention studies were eligible. Two reviewers independently screened records and charted data, with disagreements resolved by a third reviewer. Results: Of 352 records identified, five studies involving 245 participants were included. Interventions comprised virtual-reality cognitive stimulation, conventional cognitive training, group reminiscence therapy, a multicomponent music–reminiscence–reality-orientation intervention, and computerized cognitive training. In the limited technology-assisted evidence, statistically significant changes were reported in global cognition or selected memory, language, attention, and executive outcomes. Conventional cognitive training showed signals of improvement in initiative and temporary stabilization of memory, whereas reminiscence-based interventions primarily reported changes in depressive and neuropsychiatric symptoms. Where longer follow-up was available, benefits diminished over time. Conclusions: The mapped evidence suggests that structured cognitive stimulation and training may produce short-term, outcome-specific benefits in mild-to-moderate Alzheimer’s disease. Given the small and heterogeneous evidence base, these findings represent modality-related patterns within the included studies and should not be interpreted as evidence of comparative effectiveness.