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Br J Psychiatry. 2014 Jun;204(6):454-61. doi: 10.1192/bjp.bp.113.137414. Epub 2014 Mar 27.

Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial.

Author information

1
Martin Orrell, PhD, Elisa Aguirre, PhD, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Aimee Spector, PhD, Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford, and Research Department of Clinical, Educational and Health Psychology, University College London; Zoe Hoare, PhD, North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical & Social Care Research, Bangor; Robert T. Woods, MSc, DSDC Wales, Bangor University, Bangor; Amy Streater, MSc, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Helen Donovan, PsyD, Clinical Psychology Service, South Essex Partnership NHS Foundation Trust, Bedford; Juanita Hoe, PhD, Unit of Mental Health Sciences, University College London, and Research and Development Department, North East London Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science; Christopher Whitaker, MSc, North Wales Organisation for Randomised Trials in Health (NWORTH), Institute of Medical & Social Care Research, Bangor; Ian Russell, PhD, Swansea University, College of Medicine, Singleton Park, Swansea, UK.

Abstract

BACKGROUND:

There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.

AIMS:

To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).

METHOD:

The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).

RESULTS:

For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).

CONCLUSIONS:

Continuing CST improves quality of life; and improves cognition for those taking AChEIs.

PMID:
24676963
DOI:
10.1192/bjp.bp.113.137414
[Indexed for MEDLINE]
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