Cognitive Changes in Dementia Patients Following 44-Week Continuous Non-Pharmacological Treatment with Integrative Embroidery-Based Occupational Therapy: A Retrospective Study at Sirindhorn Hospital, Khon Kaen

Abstract

         Background: Dementia represents a significant public health challenge in aging populations. Sirindhorn Hospital, Khon Kaen, has initiated a 44-week Non-Pharmacological Intervention (NPI) targeting Six Cognitive Domains, utilizing embroidery, art, music, and physical activity as therapeutic modalities. Progression and psychological evaluations are systematically documented in medical records. Nonetheless, a comprehensive assessment of the program's effectiveness has yet to be undertaken.

         Objective: This study aimed to examine cognitive changes in dementia patients receiving continuous non-pharmacological treatment based on the Six Cognitive Domains framework over a 44-week period, and to assess their quality of life following treatment, using retrospective medical record data from Sirindhorn Hospital, Khon Kaen.

         Methods: This retrospective observational study reviewed medical records of patients diagnosed with dementia (ICD-10: F00-F03) at Sirindhorn Hospital during fiscal years 2024–2025 (B.E. 2567–2568). Of the 46 eligible records, 13 patients who had complete pre- and post-assessment data and participated in 44 weeks of occupational therapy were selected using purposive sampling. The assessment instruments included the MoCA, MMSE, and Bender Gestalt Test. Data analysis was performed utilizing the Paired t-test or Wilcoxon Signed-Rank Test, and effect sizes were calculated using Cohen's d.

         Results: The study included thirteen participants with a mean age of 71.2 ± 4.6 years. MoCA scores showed a statistically significant increase from 17.38 ± 2.33 to 20.85 ± 2.54 (p < 0.01, Cohen's d = 1.27; indicating a large effect size). MMSE scores rose from 20.08 ± 3.04 to 21.92 ± 2.64 (p < 0.05, d = 0.73; medium effect size). Bender Gestalt error scores demonstrated a significant decrease (p < 0.05, d = 0.66). The Visuospatial/Executive and Attention domains of the MoCA improved by +1.23 points (p = 0.004) and +0.77 points (p = 0.033), respectively. Quality of life measures increased across all assessed dimensions, with every participant reporting greater happiness, improved mood, and enhanced relaxation.

         Conclusion: A 44-week non-pharmacological intervention (NPI) targeting six cognitive domains through embroidery, art, music, and physical movement demonstrated significant improvements in cognitive function and quality of life among individuals with dementia. These results provide evidence to support broader community adoption and inform the development of national clinical practice guidelines.