What Gets Measured Gets Better: Building a Real-World Evidence Base for CST in Residential Care
Parallel 2
17 November, 2026 3:20 – 4:30 pmNaDCAS Symposium: Dementia Care Accreditation
Josefine Funder Nissen
Clinical Product Specialist
Ayla Care Limited
Summary
Cognitive Stimulation Therapy (CST) is the leading non-pharmacological intervention recommended by both NICE and the WHO for people with dementia. Yet, its reach into residential care settings remains strikingly limited.
The systematic reviews underpinning the CST evidence base recruited overwhelmingly from community-dwelling populations; memory clinics, day centres, home care settings. Care home residents, who represent a substantial proportion of people living with dementia in the UK, are largely absent from both the research literature and routine delivery. The delivery gap and the knowledge gap reinforce each other, without evidence generated in care settings, commissioners cannot act; without delivery infrastructure, evidence cannot be generated.
Care homes are not simply sites where evidence-based interventions happen to be underused, they are an untapped environment to understand how interventions work. Through data, there’s an opportunity to build a richer, more representative understanding of what CST can do, for whom, and under what conditions.
Drawing on real-world data from Ayla – a UKCA Class I registered digital CST assistant – we present findings from CST programmes delivered in residential care settings, measured across four data streams: resident wellbeing and subjective cognition, session-by-session facilitator observation, relative-reported experience, and facilitator satisfaction. Results include 98% cognitive stability (46% improvement, 52% maintained), 82% maintained or improved mood and wellbeing, and 9.6/10 resident satisfaction.
Beyond the headline findings, there’s a methodological argument: that embedded, routine outcome measurement in care homes, should become the standard of practice in residential dementia care. Not to replace clinical research, but to generate the complementary real-world layer that makes clinical findings applicable to the actual diversity of people living with dementia in care homes.