Cognitive therapy is recommended for dementia — so why can't most Australians access it?

For people living with dementia, cognitive interventions — structured activities that exercise memory, thinking and communication — are among the most strongly recommended non-drug supports available. Clinical guidelines endorse them. The evidence backs them. And yet, in Australian community settings, most people who could benefit never get the chance to try them.

That gap between what's recommended and what's actually delivered is the focus of a new paper in the Australasian Journal on Ageing by researchers at the University of Canberra (Mulhall, Gibson, Longley & D'Cunha, 2026).

What the research found

The authors set out to understand why cognitive interventions — including cognitive stimulation therapy (CST), cognitive rehabilitation and cognitive training — remain underused in Australian community-based care, despite their place in post-diagnostic support guidelines. Their synthesis points to a clear translation gap: the interventions are recommended, but practical guidance on how to deliver them in community settings is limited, and uptake is low. The paper maps the current evidence through an Australian practice and policy lens and identifies the barriers standing in the way.

The barriers are practical, not theoretical

The issue isn't whether cognitive interventions work — that question is largely settled. It's delivery. The paper highlights how limited practical guidance, workforce capacity and training, and the fragmented nature of community care combine to keep proven interventions on the shelf. In short, the recommendation exists, but the pathway to deliver it consistently often doesn't.

Why this matters right now

The timing is pointed. Australia's new rights-based Aged Care Act commenced on 1 November 2025, and the Strengthened Aged Care Quality Standards put person-centred care, dignity and reablement at the centre of what providers must demonstrate. Meanwhile, the international World Alzheimer Report 2025 reframed dementia care around rehabilitation and keeping people active and engaged. The expectation to deliver meaningful, structured engagement is rising — at exactly the moment demand is climbing.

What cognitive stimulation actually looks like

Cognitive Stimulation Therapy is a good example of an intervention with strong evidence behind it. It typically runs as a series of themed small-group sessions, delivered in person or online by trained staff or even family carers, and it's now used in dozens of countries including Australia. The activities are sociable and engaging by design — discussion, word and number games, music, reminiscence and gentle problem-solving.

The catch is that doing it well depends on trained facilitators, preparation time and consistent resources — precisely where many community and residential services are stretched thin. That's the practical wall the University of Canberra paper keeps running into.

Closing the gap with technology

This is where well-designed touchscreen technology earns its place. The right platform lowers the skill barrier — activities are ready to run, with no lengthy preparation — so any staff member can lead a session. It supports both group and one-to-one formats, works across residential and community settings, and keeps engagement consistent day to day rather than depending on who happens to be rostered on. Used well, it doesn't replace human connection; it gives carers the structure and confidence to create more of it.

The bottom line

The evidence for cognitive interventions in dementia is no longer the question. The challenge is getting them to the people who need them — reliably, in the community, every day. The University of Canberra's research names that gap clearly. For aged-care providers and the teams on the floor, closing it is both a quality obligation and a real opportunity to improve quality of life.

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Source: Mulhall S, Gibson D, Longley WA, D'Cunha NM. Improving Access to Cognitive Interventions for People With Dementia in Australian Community-Based Settings. Australasian Journal on Ageing, 2026. Prevalence figures: Australian Institute of Health and Welfare.