Please select the eligibility criteria that correspond to the clinical trial below.
Title: Adapting Individual Cognitive Stimulation Therapy (iCST) for Delivery by a Web-application
Brief Summary: In the UK, over 670,000 older people are living with dementia which has a substantial, multi-level impact on society, the person with dementia, and their carers. There is a need for an increase in the availability of psychological therapies since people with dementia can face difficulties with staying mentally stimulated and engaged. Cognitive Stimulation Therapy (CST) offers a person based approach and can help to relieve some of these problems. It is a brief manualised evidence based psychological treatment for people with mild to moderate dementia which has shown to improve cognition and quality of life. CST is currently available in both a group and individualised format called iCST. It is worthwhile to explore a computerised version of iCST since it would take together the added value of computer use and the beneficial effects of iCST which might produce combined, positive effects on cognition and quality of life. The investigators have spoken to people with dementia and their carers who are keen on using technology to stay mentally active and stimulated. This study sets out to develop and evaluate the potential benefits of an iCST web-application within a feasibility study. The effects on cognition and quality of life between (a) usual care and (b) iCST web-application over 11 weeks will be compared. A web-application is a website which can easily be accessed on and is compatible with computers and tablets. In order to create the most appropriate and practical web-application, the research team will work closely together with people with dementia, their carers, and the software company. An iCST web-application will compliment traditional CST by making it even more accessible since technology users will be able to access it easily on their device. Furthermore, a computerised version of iCST will by highly relevant for upcoming generations who have grown up with the use of technology.


Options:
A: Inclusion Criteria:

* Elderly person with 60 years of age or older;
* Diagnosis of mild or major neurocognitive disorder, performed by a physician specialized in neurology or psychiatry, or who is validated by the family physician in accordance with DSMIII/IV/5 or ICD-9/10 criteria;
* Presence of mild to moderate cognitive impairment according to the 6-Item Cognitive Decline Test (6CIT);
* Capable of communicating and understanding communication;
* Without a physical illness or significant disability (eg elderly people who are on dialysis or bedridden);
* Living in the community (in their home);
* Have an informal caregiver available and able to develop the individual cognitive stimulation program.

Exclusion Criteria:

* Elderly / informal caregiver with a history of severe psychiatric illness diagnosed before 60 years of age;
* Informal caregiver with cognitive impairment, even if mild (mild PNC according to DSM-5 criteria);
* Elderly people who do not live in their home.
B: Inclusion Criteria:

* Being flagged as a person in a socially vulnerable context.
* Being 65 years of age or over.
* Having a neurocognitive disorder according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) (2014).
* Being a native Portuguese speaker.
* Residing in the region of Ribeira de Fráguas.

Exclusion Criteria:

* Not having preserved the ability to communicate and understand.
* To suffer from a severe or acute illness that makes the participation in the sessions impossible.
* Presence of severe neuropsychiatric symptoms that prevent participation in the sessions or uncontrolled psychotic conditions.
* Being institutionalized.
C: Inclusion Criteria:

Person with dementia:

* Meet Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria for dementia (American Psychiatric Association, 2013).
* Score 10 or above on the Mini Mental State Examination (MMSE) (Folstein, Folstein, \& McHugh, 1975) or score of 16 or above on the Montreal Cognitive Assessment (MoCA) (Trzepacz et al., 2015) where available.
* Some ability to communicate and understand (e.g. ability to give informed consent)
* Ability to speak and understand English
* See/hear well enough to participate
* No major physical illness or disability affecting their participation
* Age range: 50 years - no maximum age limit
* Availability of a tablet to the person with dementia and carer
* Availability of a carer (or friend/befriender) to participate in the focus groups, interviews and iCST web-app sessions

Carer:

* Minimum age: 21
* Ability to speak and understand English
* See/hear well enough to participate
* No major physical illness or disability affecting their participation

Exclusion criteria

Person with dementia and carer:

- Concurrent participation in any other interventional study for people with dementia/carers
D: Inclusion Criteria:

Participants will be classified as either MCI patients, AD patients, or normal controls. General Inclusion Criteria will apply to all groups, with specific criteria for each group as described below:

General (applies to each category):

* Between 55 and 90 years of age (Currently, ADNI sites are only recruiting volunteers age 70-90 among people with no memory problems)
* Study partner or caregiver to accompany patient to all scheduled visits
* Fluent in English or Spanish
* Permitted medications stable for at least 4 weeks prior to screening
* Adequate visual and auditory acuity to allow neuropsychological testing
* Good general health with no additional diseases expected to interfere with the study
* Women must be two years post-menopausal or surgically sterile
* Willing and able to complete all baseline assessments, and to participate in the 2-3 year protocol
* Willing to undergo neuroimaging and provide DNA and plasma samples as specified
* Completed 6 grades of education or sufficient work history to exclude mental retardation
* Modified Hachinski score \<=4
* Geriatric Depression Scale \<6

Specific Criteria for MCI and AD patients:

* Memory complaint by patient or study partner
* Abnormal memory function score on Wechsler Memory Scale (adjusted for education)
* Mini-Mental State Exam score between 24 and 30 (MCI) or 20 and 26 (AD)
* Clinical Dementia Rating = 0.5; Memory Box score at least 0.5 (MCI) or 1.0 (AD)

Exclusion Criteria:

* Any significant neurologic disease other than Alzheimer's disease
* Abnormal baseline MRI
* Presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments or foreign objects in the eyes, skin, or body
* Major depression, bipolar disorder, history of schizophrenia
* History of alcohol or substance abuse or dependency within the past 2 years
* Any significant systemic illness or unstable medical condition which could lead to difficulty complying with the protocol
* Clinically significant laboratory abnormalities
* Residence in skilled nursing facility
* Participation in clinical studies involving neuropsychological measures being collected more than one time per year

Specific Exclusion Criteria for MCI and AD:

* Psychotic features, agitation or behavioral problems within the last 3 months which could lead to difficulty complying with the protocol.

Prohibited medications:

* Specific psychoactive medications (for example, certain antidepressants, anti-anxiety medications, sleeping pills, etc.)
* Warfarin (Coumadin)
* Investigational agents

Answer: C