Cognitive stimulation as a key strategy in vascular dementia: cognitive, functional and social benefits

Abstract

Introduction: Vascular dementia (VD), the second most common cause of dementia, is characterized by cognitive decline with prominent impairment of executive functions, attention, and processing speed. This systematic review evaluates the effectiveness of cognitive stimulation (CS) as a rehabilitation strategy in VD. Methodology: A comprehensive search was conducted in databases such as PubMed, Scopus, and the Cochrane Library up to December 31, 2025. Forty-five studies primarily randomized controlled trials, which evaluated CS in individuals with VD or mixed dementia were included. Results: The results demonstrate that CS induces clinically relevant improvements in global cognition, evidenced by an average increase of 1.99 points on the Mini-Mental State Examination (MMSE) and 2.42 points on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) [1]. These benefits are equivalent to a delay of approximately six months in the progression of cognitive decline [1], [2]. Specifically for vascular dementia (VD), cognitive exercise (CE) demonstrated improvements in working memory and cognitive flexibility [5]. Furthermore, benefits were observed in communication, social interaction, and instrumental activities of daily living (IADLs), along with a reduction in the perceived burden on caregivers [1]. Efficacy was greater in group interventions and with more frequent sessions. Despite the heterogeneity in study designs, CE is a fundamental non-pharmacological intervention for VD. Conclusion: CE is an effective rehabilitation strategy that improves cognitive performance, functionality, and quality of life in patients with VD. Future research should focus on VD-specific protocols, longitudinal studies, and the optimization of intervention parameters.