Depressão, ansiedade e estado mental em pacientes com demência em estágio inicial: comparação entre a terapia de reminiscência e a terapia de estimulação cognitiva

Demir, Zeynep Gümüş; Doğan, Idil Arasan; Keskin, Remziye; Koyutürk, Defne Demet

doi:10.1590/1980-5764-DN-2025-0354

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Original Article • Dement. neuropsychol. 20 • 2026 • https://doi.org/10.1590/1980-5764-DN-2025-0354 linkcopiar

Depressão, ansiedade e estado mental em pacientes com demência em estágio inicial: comparação entre a terapia de reminiscência e a terapia de estimulação cognitiva

Autoria SCIMAGO INSTITUTIONS RANKINGS

Intervenções psicossociais podem direcionar de forma diferenciada sintomas afetivos e cognitivos na demência leve, porém as evidências comparativas em instituições de longa permanência são limitadas.

Objetivo: Comparar os efeitos da Terapia de Reminiscência (TR) e da Terapia de Estimulação Cognitiva (TEC) sobre depressão, ansiedade e funcionamento cognitivo em idosos com demência leve residentes em instituições de longa permanência.

Métodos: Estudo quantitativo, quase-experimental, realizado com 24 participantes diagnosticados com demência leve, distribuídos igualmente entre TR (n=12) e TEC (n=12). Treze eram do sexo masculino e onze do sexo feminino. Os dados foram coletados por meio de um Formulário de Informações Sociodemográficas, da Escala de Depressão Geriátrica (EDG), do Inventário de Ansiedade de Beck (IAB) e do Mini Exame do Estado Mental (MEEM) padronizado. Ambos os grupos receberam 10 sessões semanais com duração de 90 minutos cada.

Resultados: Padrões distintos emergiram entre as intervenções. A TR mostrou-se mais eficaz para os sintomas emocionais: os sintomas depressivos reduziram significativamente (t(11)=8,26; p<0,001) e a ansiedade também apresentou melhora (t(11)=10,41; p<0,001). A TEC resultou em maiores ganhos no desempenho cognitivo (t(11)=-2,42; p=0,034), além de reduzir sintomas depressivos (t(11)=3,08; p=0,010) e de ansiedade (t(11)=5,05; p<0,001). Esses efeitos diferenciais sugerem mecanismos terapêuticos específicos.

Conclusão: Tanto a TR quanto a TEC podem oferecer benefícios psicossociais relevantes para idosos com demência leve. Os achados ressaltam a necessidade de estratégias de intervenção individualizadas, que considerem o perfil emocional e cognitivo de cada pessoa ao planejar cuidados em saúde mental em instituições de longa permanência.

Palavras-chave:
Demência; Depressão; Ansiedade; Cognição; Terapêutica

Reminiscence Therapy Program	Subject
Session 1	• Welcome and introduction of the session host • Explanation of group rules • Self-awareness, awareness of others, and identification of goals and process • Self-introduction of each participant, with support if needed • Sharing names, nicknames (if any), place and date of birth, occupations, and hobbies • Summarizing activities and discussing group interactions
Session 2	• Welcome and introduction of the session host • Reminder of group rules • Reviewing what was discussed in the previous week • Promoting hopefulness and life review • Recalling school memories; for those who cannot recall, supporting recall through group prompts • Summarizing activities and discussing interactions
Session 3	• Welcome and introduction of the session host • Reminder of group rules • Reviewing what was discussed in the previous week • Recalling childhood games, with supportive cues for those who have difficulty remembering • Summarizing activities and discussing interactions • Discussing the place and conditions in which participants live, comparing past and present
Session 4	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Discussing national and religious holidays; using related photographs as visual aids • Supporting personal memory within this context • Summarizing activities and discussing interactions
Session 5	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Discussing relationships and marriage • Married participants sharing memories from their wedding ceremonies • Participants who are single may share memories of past relationships or personal reflections on the topic • Summarizing activities and discussing interactions
Session 6	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Discussing an object participants carry with them or particularly like. • Summarizing activities and discussing interactions • Announcement to bring photographs to the next session
Session 7	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Displaying and discussing the photograph each participant brought, including the person in the photo and the associated memory • Discussing meaningful life events and their personal impact • Summarizing activities and discussing interactions
Session 8	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Sharing favorite music and artists; listening to the selected songs and, if possible, singing together • Discussing the artist and the significance of the song • Summarizing activities and discussing interactions
Session 9	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Discussing family life and relationships with family members • Using the “Circle” technique from the Interpersonal Therapeutic Approach during discussion • Summarizing activities and discussing interactions • Discussing materials needed for the closing party the following week
Session 10	• Welcome and introduction of the session host • Reviewing what was discussed in the previous week • Organizing a closing party using the materials available • Sharing memories of simultaneous or individual celebrations • Reviewing what was completed throughout the ten-week program • Closing remarks and final announcement

Cognitive Stimulation Therapy Program	Subject
Session 1	• Welcome and introduction of the session host • Explanation of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Generating name options for the group and reaching a consensus • Distributing a sheet with flowers drawn on it and asking participants to color according to their emotions. • Discussing the meaning of the chosen colors • Determining a group song and singing it together • Group photograph session
Session 2	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Using a cloth ball, participants describe themselves it is thrown to them. • Singing the group song together • Group photograph session
Session 3	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Using a cloth ball, participants describe happy and unhappy times when he ball is thrown to them. • Throwing the ball into a basket and recalling each scored number • Singing the group song together • Group photograph session
Session 4	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Distributing papers for writing memories of childhood and youth; group discussion afterward • Drawing the environment/room where participants lived while growing up and discussing the drawings • Singing the group song together • Group photograph session
Session 5	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Preparing a dinner menu from items placed on the table • Each participant describes their experience in detail • Singing the group song together • Group photograph session
Session 6	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Discussing a written narrative by collecting input from each participant • Discussing gender roles • Discussing behaviors of younger and older generations • Planting plants and assigning each participant responsibility for monitoring growth, recording the planting date • Singing the group song together • Group photograph session
Session 7	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Analyzing and discussing photographs of notable individuals, historical sites, and landscapes • Each participant describes details in the photographs (e.g., similarities, differences, colors, theme, etc.) • Participants draw pictures of places they have previously visited before and discuss the memories. • Singing the group song together • Group photograph session
Session 8	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Writing incomplete sentences and asking participants to complete them • Sharing experiences regarding what made them happy or unhappy during the week • Singing the group song together • Group photograph session
Session 9	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Finding and placing appropriate shapes on the floor • Working with clay dough to create figures based on model images; labeling the work with the creator’s name and planning to bring it in the next session • Announcement to bring the grown plant to the next session • Singing the group song together • Group photograph session
Session 10	• Welcome • Joint reminder of group rules • The practitioner writes the date on the board (day, month, year). • Writing the season and weather on the board • Group discussion reviewing activities carried out across all sessions, written on the board • Reviewing the grown plant • Displaying the clay figures on a table • Digital sharing of the photo album created across sessions; printed albums are distributed to participants • Singing the group song together • Ending the program with closing remarks and well-wishes

Dependent Variables	Reminiscence therapy group (n=12)		Cognitive stimulation therapy group (n=12)		t	p-value
Dependent Variables	$\bar{X}$	SS	$\bar{X}$	SS	t	p-value
Geriatric Depression Scale (pre-test)	6.75	2.14	8.25	2.90	-1.44	0.163
Standardized Mini-Mental Test (pre-test)	20.33	2.19	19.75	1.96	0.69	0.499
Beck Anxiety Inventory (pre-test)	14.00	2.98	14.33	3.47	-0.25	0.803

Dependent Variables	Pre-test (n=12)		Post-test (n=12)		t	p-value
Dependent Variables	$\bar{X}$	SS	$\bar{X}$	SS	t	p-value
Geriatric Depression Scale	6.75	2.14	4.17	1.59	8.26	<0.001***
Standardized Mini-Mental Test	20.33	2.19	20.50	2.24	-1.48	0.166
Beck Anxiety Inventory	14.00	2.98	6.00	1.35	10.41	<0.001***

Dependent variables	Pre-test (n=12)		Post-test (n=12)		t	p-value
Dependent variables	$\bar{X}$	SS	$\bar{X}$	SS	t	p-value
Geriatric Depression Scale	8.25	2.90	6.00	2.30	3.08	0.010**
Standardized Mini-Mental Test	19.75	1.96	20.58	1.78	-2.42	0.034*
Beck Anxiety Inventory	14.33	3.47	8.42	2.75	5.05	<0.001***

Dependent Variables	Reminiscence therapy group (n=12)		Cognitive stimulation therapy group (n=12)		t	p-value
Dependent Variables	$\bar{X}$	SS	$\bar{X}$	SS	t	p-value
Geriatric Depression Scale (post-test)	4.17	1.59	6.00	2.30	-2.28	0.033*
Standardized Mini-Mental Test (post-test)	20.50	2.24	20.58	1.78	-0.10	0.920
Beck Anxiety Inventory (post-test)	6.00	1.35	8.42	2.75	-2.74	0.012*

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[TFN1] Notes: ***p<0.001; **p<0.01; *p<0.05. Test Used: Independent Samples t-Test.