Yes / Objectives: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves
everyday functioning for people with mild-to-moderate dementia.
Design and methods: Parallel group multi-centre single-blind randomised controlled trial (RCT)
comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an
ICD-10 diagnosis of Alzheimer’s, vascular or mixed dementia and mild-to-moderate cognitive
impairment (MMSE score ≥ 18), and with a family member willing to contribute. Participants
allocated to CR received ten weekly sessions over three months and four maintenance sessions over
six months. Participants were followed up three and nine months post-randomisation by blinded
researchers. The primary outcome was self-reported goal attainment at three months. Secondary
outcomes at three and nine months included informant-reported goal attainment, quality of life, mood,
self-efficacy, and cognition, and study partner stress and quality of life.
Results: We randomised (1:1) 475 people with dementia; 445 (CR=281) were included in the
intention to treat analysis at three months, and 426 (CR=208) at nine months. At three months there
were statistically-significant large positive effects for participant-rated goal attainment (d=0.97, 95%
CI 0.75 to 1.19), corroborated by informant ratings (d=1.11, 0.89 to 1.34). These effects were
maintained at nine months for both participant (d=0.94, 0.71 to 1.17) and informant ratings (d=0.96,
0.73 to 1.2). The observed gains related to goals directly targeted in the therapy. There were no
significant differences in secondary outcomes.
Conclusions: Cognitive rehabilitation enables people with early-stage dementia to improve their
everyday functioning in relation to individual goals targeted in the therapy. / National Institute for Health, Health Technology Assessment Programme, Grant/Award Number: 11/15/04
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/16887 |
| Date | 06 February 2019 |
| Creators | Clare, L., Kudlicka, A., Oyebode, Jan, Jones, R.W., Bayer, A., Leroi, I., Kopelman, M.D., James, I.A., Culverwell, A., Pool, J., Brand, A., Henderson, C., Hoare, Z., Knapp, M., Woods, B. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © 2019 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
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