BACKGROUND:

A recent Cochrane review of reality orientation therapy identified the need for large, well-designed, multi-centre trials.

AIMS:

To test the hypothesis that cognitive stimulation therapy (CST) for older people with dementia would benefit cognition and quality of life.

METHOD:

A single-blind, multi-centre, randomised controlled trial recruited 201 older people with dementia. The main outcome measures were change in cognitive function and quality of life. An intention-to-treat analysis used analysis of covariance to control for potential variability in baseline measures.

RESULTS:

One hundred and fifteen people were randomised within centres to the intervention group and 86 to the control group. At follow-up the intervention group had significantly improved relative to the control group on the Mini-Mental State Examination (P=0.044), the Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) (P=0.014) and Quality of Life - Alzheimer's Disease scales (P=0.028). Using criteria of 4 points or more improvement on the ADAS-Cog the number needed to treat was 6 for the intervention group.

CONCLUSION:

The results compare favourably with trials of drugs for dementia. CST groups may have worthwhile benefits for many people with dementia.