• cognitive function;
  • dementia;
  • music;
  • Progressively Lowered Stress Threshold model

Aim.  This aim of this study is to propose a conceptual framework for guiding interventions to enhance the cognitive function of people with dementia.

Background.  Few studies have been published on non-pharmacological approaches with a conceptual framework for an intervention to enhance cognitive function. The Progressive Lowered Stress Threshold model is one of the useful theoretical models for predicting the occurrence of dysfunctional behaviour in people with dementia. Based on the theoretical assertion of the Progressive Lowered Stress Threshold model and empirical findings on the relationship of anxiety and depression with cognitive function, an expanded model is proposed.

Design.  Discursive paper.

Method.  Literature regarding stress and anxiety in people with dementia was reviewed and critically analysed, and then integrated into the Progressive Lowered Stress Threshold Model. With careful considerations about the relationships between the variables indicated in the Model and the evidences and limitations suggested in the literature reviewed, an expanded model has been proposed, which may guide the development of non-pharmacological intervention for promoting cognitive functions of people with dementia. Recommendations or implications for practice have been given.

Conclusion.  There are three commonly used models in dementia care, including the biomedical, behavioural and Progressively Lowered Stress Threshold model. Their uses and weaknesses are given. An expanded model is suggested, and explanations are provided with regard to its merits in guiding the development of interventions for people with dementia. Further testing on this model is suggested.

Relevance to clinical practice.  Cognitive function and dysfunctional behaviour are the major concerns of caregivers of dementia patients. Interventions that can alleviate the symptoms and enhance cognition are likely to improve the well-being of patients and their caregivers. This purposed model can guide the development of interventions.