Effects of Art Therapy-Based Cognitive Stimulation Program on Dementia Risk Among Older Adults in the Community

Abstract

Introduction Dementia is a major public health concern among older adults worldwide. The World Health Organization reports that approximately 55 million people are currently living with dementia, and this number is projected to rise to 78 million by 2030. Thailand has officially entered a complete aged society since 2021. Older adults in community settings who experience declines in their ability to perform activities of daily living are at heightened risk of dementia due to limitations in mobility, reduced social interaction, and insufficient cognitive stimulation. Cognitive stimulation through creative activities, such as art therapy, has been shown to enhance brain function, improve memory, reduce stress and anxiety, foster self-esteem, and alleviate social isolation, all of which are factors associated with lowering dementia risk. Nevertheless, research on the application of art therapy among older adults with mobility limitations in community contexts in Thailand remains scarce.

Objective This study aimed to compare dementia risk scores among community-dwelling older adults before and after participating in an Art Therapy-Based Cognitive Stimulation Program.

Design A quasi-experimental one-group pretest–posttest design was employed to test a program integrating Stern’s Cognitive Reserve theory, the concept of Neuroplasticity, and Judith A. Rubin’s art therapy framework. The intervention comprised four types of activities: Color Stories of Mine, Touch and Shape Feelings, Crafts from My Heart, and Life Reflection Collage. Sessions were conducted once weekly, lasting 60–90 minutes each, over a total period of 10 weeks.

Methodology The study sample consisted of 40 older adults aged 60 years and above who scored between 5 and 11 on the Barthel ADL Index. All participants were registered at a subdistrict health-promoting hospital in Mueang Pathum Thani District, Pathum Thani Province, between September and December 2025. Purposive sampling was used, with inclusion criteria including an AD8 score ≥ 2, the ability to communicate in Thai, and willingness to participate in the study. Research instruments included the program manual, the Barthel ADL Index, and the AD8 Dementia Screening Interview. Data were collected between September and December 2025 at a subdistrict health-promoting hospital located in a central province of Thailand. Data were then analyzed using Descriptive statistics and Paired t-test.

Results The majority of participants were female (60%), with a mean age of 72.3 years (SD = 7.24). Most identified as Buddhist (94%) and had completed primary education (45%). Hypertension was the most prevalent chronic condition (65%). Following participation in the program, the mean AD8 score decreased significantly from 2.82 (SD = 0.89) at baseline to 2.22 (SD = 1.08) post-intervention (t = 6.958, p < .001). Cohen’s d = 0.673 indicated a mediumto- large effect size. AD8 Score decreased in 55% of participants, 37.5% remained stable, and increased in 7.5%.

Recommendation Nurses and healthcare personnel can apply the four program activities in community-based care for older adults. Village health volunteers may be trained to serve as facilitators, while families can be encouraged to implement activities at home regularly to promote cognitive stimulation. Future studies should incorporate a control group and include long-term follow-up to strengthen the evidence base.