Reminiscence approach as a method of activating cognitive functions in seniors
Introduction
In community nursing practice, reminiscence intervention is characterized as a targeted conversation of a recollective nature. The conversation recalls past life, previous activities, experiences, and significant life events. Supportive aids are used, such as old photographs, personal items, household tools, various historical devices, fashion accessories, films, folk or dance music. They help evoke memories and support communication and emotional experience in seniors. These stimuli are non-verbal and creative. An example is the so-called "memory box," whose contents include small objects (a diary, a favorite book, a locket, etc.) that support the process of remembering (Ondiová, Fertaľová, 2022). Memories can also have a negative focus on traumatic events that the senior must come to terms with (Janečková, Vacková, 2010). The goal of the reminiscence approach is to stimulate the senior's cognitive functions, improve their overall health, and provide psychosocial support. The risk of loneliness is eliminated, and quality of life improves, as evidenced by the senior's ability to meet the need for autonomy and independence in daily activities. Returning to past sensory perceptions and emotions reduces the deficit in long-term memory (Katona, 2024). Malíková (2020) describes the so-called memory room, whose furnishings correspond to the period of the senior's youth. Family members can be involved in the process of the reminiscence approach (Holczerová, Dvořáčková, 2013). The approach is adapted to the senior's needs and life pace, while respecting their experience of memories is a fundamental prerequisite for preserving dignity and a positive experience (Ondriová, Fertaľová, 2022). The reminiscence approach is part of a broader framework of non-pharmacological methods recommended for working with seniors with dementia and other cognitive disorders. In community nursing care, its implementation requires multidisciplinary collaboration, within which individual professionals – especially a special education teacher, psychologist, geriatrician, nurse, and social worker – apply their specific competencies in accordance with professional standards. The nurse holds a significant position in this process, as they can integrate the reminiscence approach into the individual nursing plan as part of comprehensive nursing care for the senior, continuously monitor their reactions, and evaluate the effect of the intervention. The special education teacher provides therapeutic guidance for reminiscence activities, while other team members support the process from medical, psychological, and social perspectives. This procedure is in line with the Standard Diagnostic and Therapeutic Procedures – Non-pharmacological Methods and Approaches in the Treatment of Dementias, which emphasize the importance of the reminiscence technique as an effective form of supporting the senior's memory, communication, self-confidence, and dignity (Čunderlíková, Kiseľáková, Zigmundová, 2021).
Objective
To evaluate the impact of reminiscence interventions on the health of a selected group of seniors.
Sample and methodology
We included five female individuals (R1-R5) aged 72 to 85 years in the reminiscence approach. We conducted 7 group reminiscence interventions (S1-S7), thematically focused on recalling family relationships, work experiences, and daily activities. The intervention plan had three phases. In the first (T1) and third phases (T3), we compared the cognitive function test score (MMSE) and the state of dementia or depression on the Geriatric Depression Scale (GDS). Using the method of participant observation, we evaluated reminiscence stimulation (RMS) in the areas of cognitive communication skills, emotional experience, motivation and cooperation, and engagement in the activity. We assessed the subjective experience of the reminiscence interventions using a self-constructed questionnaire. It consisted of 6 closed-ended items. Respondents' answers were recorded on a three-point visual scale. The subjective experience score is illustrated in Table 1.
Table 1 Subjective experience score
Results
In your group of 5 patients, initial MMSE scores (T1) ranged from 21 to 23 points, indicating the presence of mild dementia. After the intervention (T3), two patients showed an increase in score (improvement in cognitive abilities), and the remaining three showed stabilization at the same level. At the beginning (T1), respondents had scores from 8 to 11 points (presence of depressive symptoms). After the intervention (T3), the scores of four of them decreased significantly (e.g., from 8 to 3 or from 11 to 6), indicating that the intervention significantly improved their psychological well-being and mood. The greatest progress was shown by R1 and R2, where improvement occurred in most cognitive and emotional indicators, and the depression score decreased significantly (Table 2). A stable state without significant changes was shown by R3, who experienced a single slight worsening on the GDS scale (from 11 to 12). Motivation and environment remained stable at the original level for all respondents. The average score improvement for the entire group of 5 respondents shows a positive trend after the intervention in the areas of cognitive function and depressive symptoms, which receded.
Table 2 Overview of changes in assessed areas [
](https://www.prohuman.sk/files/images/tab2-prehlad-zmien.png) Legend: R=respondent, MMS= Mini-Mental State Examination, GDS= Geriatric Depression Scale, RMS=reminiscence stimulation, T1=before intervention, T3=after intervention
The initial measurement of cognitive status using the MMSE test in phase T1 revealed the presence of mild cognitive deficit to mild dementia in all respondents, with scores ranging from 21 to 23 points. After completing the intervention program (T3), the entire group experienced an average improvement in cognitive score of +0.80 points. A significant shift of +2 points was recorded in two respondents (R 1 and R2) (from 21 to 23 points, and from 22 to 24 points, respectively), indicating a strengthening of cognitive plasticity and successful stimulation of cognitive processes (especially memory, attention, and orientation). In the remaining three respondents (R3, R4, and R5), the MMSE score remained stable. However, in the context of neurodegenerative processes or chronic cognitive disorders, even the stabilization of the condition and prevention of disease progression is considered a clinically successful outcome of the intervention. The most pronounced positive effect of the intervention was manifested in the area of emotional experience and the level of depression measured by the GDS scale. The initial screening showed borderline values or the presence of moderate depression in most participants (range 8 to 11 points). On average, the depressive score decreased by -2.60 points after the intervention, representing a major success in improving patients' quality of life. The most significant turnaround again occurred in respondent 1 (decrease of 5 points, from 8 to 3 points) and respondent 2 (decrease of 5 points, from 11 to 6 points), moving these subjects from the clinical depression range to the normal range or mild emotional lability. Respondents 4 and 5 also showed slight improvement (both a decrease of -2 points). The only negative fluctuation was recorded in respondent 3, where the GDS score slightly increased from 11 to 12 points. This condition may be caused by other exogenous factors (e.g., current health status, change in personal situation), as the cognitive functions of this patient remained unchanged (Tab. 3).
Tab. 3 Comparison of changes – evidence of the impact of reminiscence interventions on health
Legend: R=respondent, MMS= Mini-Mental State Examination, GDS= Geriatric Depression Scale, RMS=reminiscence stimulation, R=respondent
From a qualitative perspective, the majority of respondents experienced stabilization or improvement in emotional experience (a shift from unstable or partially stable experience to stable experience). The intervention had a positive effect on the respondents' communication skills, activation, and social interaction. A very important factor for success was high motivation and willingness to cooperate. A supportive and conducive environment created optimal conditions for achieving these results.
Discussion
When comparing our findings with the international research context, we find significant correspondence in trends, although our sample (N = 5) is characterized by specific individual variability. In the area of cognitive functions, our sample achieved an average increase and experienced stabilization of their condition. This result is consistent with findings published by Rovner et al. (2021) in their extensive study focused on multi-domain cognitive interventions. The authors confirmed that systematic stimulation provides the greatest benefit precisely in subgroups of patients with baseline MMSE scores lower than 26 points, where they recorded an average increase and stabilization of scores compared to an untreated control group. Similarly, Woods et al. (2023) in their extensive review confirm that regular cognitive stimulation in mild to moderate dementia brings measurable benefit, which on average corresponds to approximately a 6-month delay in natural cognitive decline. Our findings on the stabilization of the condition in three patients thus confirm the validity of this international consensus at the micro level.
Our results in the area of reducing depressive symptoms show an even more pronounced correlation with foreign data. Neuropsychiatric research conducted by Wang et al. (2025) repeatedly highlights the strong bidirectional relationship between depression and cognitive deficit in older adults. Long-term analyses published by Livingston et al. (2024) demonstrate that a change in the intensity of depressive symptoms directly predicts the rate of subsequent cognitive decline. This explains why our respondents with the most significant reduction in depression according to the GDS (R1 and R2 both by -5 points) simultaneously showed the best progress in the MMSE test (both by +2 points). The non-pharmacological intervention successfully broke the vicious cycle of deprivation in them: reduced apathy and improved mood freed up capacity for better cognitive performance, which is also described in their works on cognitive stimulation therapy (CST) by Spector et al. (2022). Conversely, the isolated worsening of the emotional state in R3 (+1 point on the GDS scale) with preserved MMSE stability reflects the conclusions presented by Santos et al. (2026). They point out that although these two domains are interconnected, the individual trajectory of depressive symptoms in later life is often influenced by other variables, such as subjective perception of health, anxiety, or the level of current social support, which can fluctuate independently of the objective state of cognition.
Conclusion
The measured data indicate that the program was highly effective, especially in reducing depressive symptoms, and demonstrated the ability to maintain or slightly improve the level of cognitive functions. Although the small size of the research sample (N = 5) does not allow generalization of the results to the entire population, the individual successes of individual cases clearly point to the importance of non-pharmacological approaches and regular activation in old age.
Authors:
prof. PhDr. Mária Kilíková, PhD., MPH
Mgr. Lenka Klímová
VŠZ a SP sv. Alžbety v Bratislave, n.o., Detašované pracovisko bl. Sáry Salkaházi v Rožňave
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