Characteristics of Included Studies

MethodsParticipantsOutcomesInterventionsNotes
BAINES1987
Study Type: RCT (individual)

Study Description: Cross-over trial + no treatment group

Blindness: No mention
Duration (days): Mean 56

Setting: Residents of a large local authority home in UK with moderate/severe impairment of cognitive function
Info on Screening Process: 20 screened: 3 excluded because of communication problems, 2 excluded because they didn't have cognitive impairment
n= 15
Age: Mean 82
Sex: 1 male 14 females :
Diagnosis:

Exclusions: Severe communication problems, <moderate cognitive impairment (according to Information/Orientation and Mental ability scores of the CAPE)

Baseline: Group A: information/orientation = 5.4, mental ability = 6.8; Group B: information/orientation = 5.8, mental ability = 8.2; Group C (control): information/orientation = 5.9, mental ability = 7.4
Data Used
 Information/orientation (CAS)
 Behaviour Rating Scale (CAPE)
 Mental ability (CAS)
Group 1 N= 5
Reminiscence Therapy with - Group met for 30 mins/day Monday-Friday for 4 weeks. Set of 6 audio/slide programmes used to facilitate reminiscence from Help the Aged, old photographs of local scenes, residents' personal photos, books, magazines, newspapers
 Reality Orientation with - Group met for 30 mins/day Monday-Friday for 4 weeks. Used a large board for recording day, month, weather, writing materials, old newspapers etc. Also used materials to stimulate all 5 senses (e.g. distinctive smells, vials of rose water)
Group 2 N= 5
 No treatment with
Group 3 N= 5
Reminiscence Therapy with - Group met for 30 mins/day Monday-Friday for 4 weeks. Set of 6 audio/slide programmes used to facilitate reminiscence from Help the Aged, old photographs of local scenes, residents' personal photos, books, magazines, newspapers
 Reality Orientation with - Group met for 30 mins/day Monday-Friday for 4 weeks. Used a large board for recording day, month, weather, writing materials, old newspapers etc. Also used materials to stimulate all 5 senses (e.g. distinctive smells, vials of rose water)
Study Quality 1+
BAKER2003
Study Type: RCT (individual)
Type of Analysis: Intention to treat
Blindness: Open
Duration (days): Mean 30
Followup: One month after sessions

Setting: Multi-centre trial: UK (patients of a day hospital), Netherlands (residents of a psychogeriatric ward), Sweden (residents of a psychogeriatric ward)
Info on Screening Process: 20 participants from Netherlands sample excluded before randomization: 8 transferred to another ward, 5 died, 3 not given informed consent, 4 carers did not respond to original letter
n= 117
Age: Mean 82
Sex: no information
:
Diagnosis:
Alzheimer’s disease
 :
 :
 Mixed Dementia
 :
 :
Vascular Dementia
 :
 :
Exclusions: Exclusions: no informed consent from consultant psychiatrist or family members; no diagnosis of Alzheimer's, vascular or mixed dementia; major psychiatric co-morbidities; confined to bed; MMSE >17;

3 participants dropped out during study: 2 died in the Netherlands MSS group, 1 participant in the UK activity group was hospitalised and was excluded from the analysis
Swedish data not included in analysis because of high drop outs (2 died and 3 refused treatment) and small sample size(n=16)

Baseline: MMSE: UK MSS group = 8.8, Activity group = 6.5; Netherlands MSS group = 12.1, Activity group = 7.8, p=.05; Centres combined MSS group = 9.4, Activity group = 6.7, p=.01; GIP (Netherlands only): MSS group = 44.6, Activity group = 53.6, p<.05
Data Used
 Behaviour and Mood Disturbance Scale
 REHAB
 Behaviour Rating Scale (CAPE)
MMSE
Group 1 N= 62
 Active control with - 8 standardized sessions (duration of 30 minutes), over 4 weeks, twice a week. Directive, no intended special multi-sensory experience, patterned often sequential stimuli, intellectual/physical demands specific to the task.
Group 2 N= 55
 Multi-sensory stimulation with - 8 standardized sessions (duration of 30 minutes), for 4 weeks, twice a week. Non- directive and enabling, special effects to stimulate all senses except taste, unpatterned non-sequential stimuli, no intellectual demands
Study Quality: 1+
BREUIL1994
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 37

Setting: Outpatients in France
Notes: ADL was assessed without blinding
n= 56
Age: Mean 77
Sex:
:
Diagnosis:
 Multi-infarct dementia by CERAD
 :
 :
 100% Unspecified dementia by DSM III
 :
 :
Alzheimer’s disease by CERAD
 :
 :
Parkinson's Disease and dementia by CERAD
 :
 :
Exclusions: CERAD exclusion criteria: MMSE > 9; impaired hearing and vision severe enough to intefere with tests; severe aphasia; behavioural disorder incompatible with integration within a group for an hour; dementia due to potentially treatable causes

5 excluded because they did not attend all evaluation and training sessions
Data Used
MMSE
CERAD: neuropsychological tests
Notes: CERAD tests: 4 items not used because of ceiling effects (e.g. naming procedure, constructional praxis, word list recognition); 1 item (word list recall) not used because of floor effects - only 2 items used (word list, verbal fluency)
Group 1 N= 29
 No treatment with
Group 2 N= 32
 Cognitive Stimulation with - 10 sessions, of 1 hour, over 5 weeks e.g. shown dotted outline of umbrella and asked to join dots. Then asked to draw umbrella closed and upside down to evoke associated words (e.g. rain, raincoat, boots), to talk about rainy months and regions of France
Study Quality: 1+
CAHNWEINER2003
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 42
Followup: 8 weeks

Setting: People with mild Alzheimer's disease in a US university-based AD and memory disorder clinic.
Info on Screening Process: 5 withdrew due to transportation problems getting to the clinic
n= 34
Age: Mean 78
Sex: 20 males 14 females
:
Diagnosis:
 100% Alzheimer’s disease by NINCDS-ADRDA
 :
 :

Baseline: MMSE: Memory training group = 24.3, Control group = 25.1
Group 1 N= 17
 Active control with - A weekly 45 minute group in which educational information about aging and dementia was presented. Topics included: overview of memory; changes in cognitive function with normal aging; dementia/AD overview; depression, anxiety, and sleep disturbance
Group 2 N= 17
 Memory Training with - 6 sessions over a period of 6 weeks based on the ACTIVE study (Jobe et al 2001). Includes instruction and extensive practice in multiple mnemonic strategies (e.g. organizing stimulus items into meaningful categories, organizing ideas and details)
Study Quality: 1+
CORBEIL1999
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 84
Followup: 9 months

Setting: Community dwelling people with dementia and carer dyads in the US
Notes: Some assessors were not blinded; Carers: 20 men and 67 women; mean age = 67.1 years;
People with dementia: 56 men and 31 women; mean age = 74.2 years
Info on Screening Process: No screened = 132 people with dementia and carer dyads No. excluded = 37 excluded because they didn't meet inclusion criteria, 8 excluded because they did not provide complete data up to follow up
n= 87
Age: Mean 74
Sex:
:
Diagnosis:
 100% Alzheimer’s disease
 :
 :
Exclusions: Both members <40 years; members not living together, carer doesn't have primary responsibility for the person with dementia; did not have a confirmed diagnosis of possible or probably alzheimer's disease; person with dementia < mild and >moderate range of GDS;
Data Used
Dementia Rating Scale
Notes: All other outcomes composites of scales - validity of composites not investigated
Group 1 N= 28
 Memory Training with - 6 days a week, for 1 hour, over 12 weeks. Carers were trained each week in activites to stimulate their partner in areas of memory, problem solving, and conversational fluency
Group 2 N= 28
Placebo with - 6 days a week for 1 hour over 12 weeks. Followed same time frames and had the same exposure to the researchers as did the experimental condition. Only difference was that the activities were passive e.g watching TV without encouraging active involvement.
Group 3 N= 31
 Waitlist with - On waitlist for 9 months then offered treatment. Due to continued deterioration only 5 dyads opted for complementary sessions
Study Quality: 1+
DAVIS2001
Study Type: RCT (individual)

Study Description: placebo group crossed over after 5 weeks of treatment to the intervention for a further 5 weeks

Blindness: Single blind
Duration (days): Mean 70

Setting: Alzheimer's disease research centre at Baylor College of Medicine, Texas USA
n= 37
Age: Mean 71
Sex: 16 males 21 females
:
Diagnosis:
 100% Alzheimer’s disease by NINCDS-ADRDA
 :
 :

Baseline: MMSE: placebo group = 22.78, intervention group = 21.84; GDS: placebo group = 5.67, intervention group = 4.37
Data Used
 WMS-R Visual Reproduction
MMSE
 WMS-R Logical Memory
 Wechsler Adult Intelligence Scale-Digit Span
Group 1 N= 18
Cognitive training with - after active control of 5 weeks crossed over to receive cognitive training
Placebo with - Individual weekly 1 hour sessions for 5 weeks. Unstructured conversation and questioning by the examiner. Asked how memory was doing and had patients recite overlearned material (e.g. alphabet, months of year). Also watched health videos.
Group 2 N= 19
Cognitive training with - 1 hour sessions (individually), weekly, for 5 weeks. Began testing patient's recall of personal info, followed by spaced retrieval (not for those answered all correct), peg task, face-name training task. Also cognitive stimulation- 30 mins, 6 days/week
Study Quality: 1+
FERRARIO1991
Study Type: RCT (individual)

Blindness: No mention
Duration (days): Mean 168

Setting: Italy: institutionalized patients
Notes: Randomization not mentioned in paper but when contacted by Spector et al (2000) indicated it was randomized but gave no details of the method
n= 19
Age: Mean 83
Sex: 11 males 8 females
:
Diagnosis:
 100% Unspecified dementia by MMSE
 :
 :
Exclusions: exclusions: use of pharmacological therapies for cognitive function, anaemics, those with severe metabolic and/or cardiorespiratory failure, noisy or violent, severely incontinents, bedridden, marked visual or hearing impairment, MMSE not between 18–25

Baseline: Controls: mean for CAS: information/orientation = 7.33, mental ability = 9.33, psychomotor performance = 8.67, total score = 25.33; mean MOSES: self care functioning = 15.00, disoriented behavior = 14.67, depressed anxious mood = 11.17, irritable behavior = 12.83, withdrawn behavior = 19.50
Treatment group: mean for CAS:information/orientation = 8.15, mental ability = 7.69, psychomotor performance = 7.69, total score = 23.54; mean MOSES: self care functioning = 19.15, disoriented behavior = 12.46, depressed anxious mood = 14.69, irritable behavior = 9.38, withdrawn behavior = 17.77
Data Used
 Clifton Assessment Scale
MOSES
Group 1 N= 13
 Reality Orientation with - 1 hour formal session, 5 times a week, for 24 weeks. There was a 3 week break for Christmas and Easter holidays
Group 2 N= 6
 No treatment with
Study Quality: 1+
GOLDWASSER1987
Study Type: RCT (individual)
Blindness: Single blind
Duration (days): Mean 35

Setting: Beth Sholom Home, Virginia, US
Info on Screening Process: 1 died in reminiscence group during trial, 1 subject from both control groups dropped from analysis
n= 27
Age: Mean 82
Sex: 7 males 20 females
: Diagnosis:
 Unspecified dementia
 :
 :
Exclusions: no clinical diagnosis of dementia, no symptoms associated with dementia (confusion, disorientation, cognitive dysfunction), unable to communicate verbally, unable to function within a group without causing excessive disruption

Baseline: MMSE = 10.4
Data Used
ADL
 BDI
MMSE
Group 1 N= 9
 Social contact with - Support group focused on present or future events and problems. This group met for 30 mins twice weekly for 5 weeks.
Group 2 N= 9
 No treatment with
Group 3 N= 9
Reminiscence Therapy with - 30 mins reminiscence groups twice a week for 5 weeks.
Study Quality: 1+
HEISS1994
Study Type: RCT (individual)

Blindness: Open
Duration (days): Mean 180

Setting: Department of Neurology Cologne Unniversity Hospital, Germany
Info on Screening Process: No. people screened = 350
n= 70
Age: Range 48–79
Sex: 37 males 33 females
:
Diagnosis:
 100% Alzheimer’s disease by NINCDS-ADRDA
 :
 :
Exclusions: MMSE <13 >26; not living in the community; concurrent medication known to affect the central nervous system; Hachinski score >3
Data Used
 Corsi's tapping task
 Golin's incomplete picture task
MMSE
 Der Dementz Test: delayed recognition
Group 1 N= 18
Cognitive rehabilitation with - For 1 hour twice a week for 6 months. Participants had to solve different memory, peceptual, or motor tasks.
Group 2 N= 18
Cognitive rehabilitation with - For 1 hour twice a week for 6 months. Participants had to solve different memory, peceptual, or motor tasks.
 Phosphatisdylserine with. Mean dose 200mg - Oral phosphatidylserine 200 mg twice daily
Group 3 N= 17
 Pyritinol with. Mean dose 600mg - Oral Pyritinal 600mg twice daily
Cognitive rehabilitation with - For 1 hour twice a week for 6 months. Participants had to solve different memory, peceptual, or motor tasks.
Group 4 N= 17
 Support with - 1 hour each week for 6 months. Participants spoke about their personal problems and how they managed their daily lives. Sometimes games were used to support conversations
Study Quality: 1+
KOLTAI2001
Study Type: RCT (individual)

Blindness: No mention
Duration (days): Mean 35
Followup: 47days

Setting: Referred to the study from Bryan ADRC Neurological Disorders Clinic, US. All participants had mild to moderate dementia
n= 22
Age: Mean 73
Sex: no information
:
Diagnosis:

Exclusions: < 60 years old, <0.5 and >1.0 on Clinical Dementia Rating Scale, no evidence of cognitive compromise on neurological mental status exam, insufficient language skills required to participate in treatment

Baseline: MMSE: treatment group = 22.9 control group = 26.6, GDS: treatment group = 7.0 control group = 6.5
Data Used
CERAD: neuropsychological tests
Group 1 N= 14
 Memory Training with - 8 received individual memory training and 8 received group memory training. For group memory training participants received 5 1 hour weekly sessions. Individual memory training group received 6 one-on-one sessions.
Group 2 N= 8
 Waitlist with
Study Quality: 1+
LAI2004
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 42

Setting: 2 publically funded nursing homes in Hong Kong
Info on Screening Process: 127 screened, 26 excluded (mainly due to issues of consent or being hospitalized during recruitment) 15 dropped out during study (no longer wished to participate, later found not to meet inclusion criteria, death, hospitalized)
n= 101
Age: Mean 86
Sex: 32 males 69 females
:
Diagnosis:
 100% Unspecified dementia by DSM IV
 :
 :
Exclusions: Not able to communicate most of the time; not able to speak and understand Cantonese; any active major psychiatric disorders (e.g. schizophrenia, major affective disorders); any acute or unstable chronic medical conditions (e.g. cardiac or lung diseases, blindness, deafness)

Baseline: Intervention group: MMSE = 8.3, MDS-ADL = 22.2, Social Engagement scale = 3.6, Well Being/Ill being scale = 1.3; Comparison Group: MMSE = 9.3, MDS-ADL = 21.6, Social Engagement scale = 3.4, Well being/Ill being = 1.3; Control group: MMSE = 10.7, MDS-ADL = 20.9, Social Engagement scale = 3.6, Well being/Ill being = 1.3
Data Used
MMSE
Notes: MMSE - translated into Cantonese
Group 1 N= 36
Reminiscence Therapy with - Weekly 30 minute seesion for 6 weeks. Highly focused use of triggers that approximate the life histroy of an individual and efforts to simulate recall during conversations
Group 2 N= 30
 No treatment with
Group 3 N= 35
 Social contact with - Weekly 30 minute sessions for 6 weeks. All features same as the reminiscence condition except facilitated not to discuss their life experiences. Themes of discussion included diet and health, and social security for the elderly
Study Quality: 1+
LOEWENSTEIN2004
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 98
Followup: 3 months

Setting: Mildly impaired people with AD in the US
n= 44
Age: Mean 76
Sex: 26 males 18 females
:
Diagnosis:
 Unspecified dementia by DSM IV
 :
 :
 100% Alzheimer’s disease by NINCDS-ADRDA
 :
 :
Exclusions: Not on a stable dose of a cholinesterase inhibitor for at least 8 weeks
 Notes: Those subjects diagnosed as possible AD did not have sufficient impairment social/occupational functioning required by DSM IV for dementia diagnosis
Baseline: MMSE: Cognitive Rehab = 23.4, Control = 24.53;
Data Used
 Modified Making-Change for a Purchase Task
 Bill Paying: Balancing a Checkbook task
 Face-Name Association Task
Notes: Bill Paying and Modified Making Change Tasks were modified from the Direct Assessment of Functional Status
Group 1 N= 19
 Active control with - administered individually: comercially available computer games that matched pairs of letters, number from memory; exercises such as hangman; finding words in an array of letters; 'topic of the day' where info from recent or remote past remembered
Group 2 N= 25
Cognitive rehabilitation with - 24 sessions twice per week for a period of 12–16 weeks: Learning face-name associations by SRT and dual cognitive support; practicing time-and-place orientation; activiating procedural memory; practicing everyday activities (e.g. paying for bills)
Study Quality 1+
MORGAN2000
Study Type: RCT (individual)

Study Description: Randomisation by minimisation method, with age and relationship to caregiver stratifying variables. Home staff & family aware of treatment allocation.

Blindness: Single blind
Duration (days): Mean 84
Followup: 6 weeks

Setting: Residential home residents
Notes: Assessors only partly blind to group allocation.
Allocation concealment-unclear. available.

2 out of 19 dropped out (both from intervention group)
n= 17
Age:
Sex: no information
:
Diagnosis:
 100% Unspecified dementia by Clinical Dementia Rating Scale
 :
 :
Exclusions: Presence of florid psychosis and severe communication difficulty; no carer or relative who agreed to support the intervention.
Data Used
 Autobiographical Memory Interview
 Geriatric Depression Scale
 Life Satisfaction Index
Notes: Assessments were carried out immediately before and after the intervention period and at 6 week follow-up
Group 1 N= 9
 No treatment with
Group 2 N= 8
Reminiscence Therapy with - Ave.12 individual weekly sessions, following Haight's Life Review Experiencing Form (Haight 1992); a life story book was developed for each person in the intervention group, incorporating the person's own words, accompanied by appropriate pictures.
QUAYHAGEN2000
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 56

Setting: Participants recruited through Alzheimer’s Association, Alzheimer’s Disease Researcvh Centre and public media, in the US
n= 103
Age: Mean 73
Sex: no information
:
Diagnosis:
 Multi-infarct dementia
 :
 :
Alzheimer’s disease
 :
 :
Parkinson’s Disease and dementia
 :
 :
Exclusions: Not diagnosed with possible or probable AD, multi-infarct dementia, or Parkinson’s dementia; <mild >moderate dementia as defined by GDS;
Data Used
 Marital Needs Satisfaction Scale
 Memory and Behavior Problems Checklist
 Brief Symptom Inventory
Notes: Memory outcomes were measured with unvalidated composite scales therefore not included.
Group 1 N= 16
 Day care with - Provided respite care and education/training opportunities for caregivers,Patients met for 4 hours/week and participated in activities: social time, exercise, and recreational sports, monthly outings. Caregivers met monthly in support group.
Group 2 N= 15
 Waitlist with - Waited 8 weeks before being randomized to 1 of the 4 interventions
Group 3 N= 29
 Dyadic counselling with - problem (conflict) identification, stress reduction, anger/frustration management, communication enhancement, conflict resolution. Incorporated both CBT approach and learning problem solving skills.
Group 4 N= 22
 Support with - Dual supportive seminar groups: all participants initially met for 1.5 hours for intro. Remaining 7 sessions patients and their carers met seperately for first hour and simultaneously for the last half hour to discuss specific topics
Group 5 N= 21
 Memory Training with - 1 hour daily for 5 days each week over 8 weeks. Caregiver as intervening agent who helped cognitively stimulate patient though memory provoking, problem solving, and conversational fluency activities.
Study Quality: 1+
ROBB1986
Study Type: RCT (individual)

Blindness: Open
Duration (days): Mean 270

Setting: 400 bed long-term care division of a large Veterans Administration Medical Center.
Info on Screening Process: 60 screened, 36 met eligibility criteria
n= 27
Age: Mean 81
Sex: all males
:
Diagnosis:
 69% Unspecified dementia
 :
 :
Exclusions: Excluded: <60 years old; <moderately disoriented; disoriented due to Alzheimer’s disease, Pick’s Huntington’s chorea, or cerebovascular accident within 6 months; likely to be discharged within 6 months

During the study 9 subjects were excluded because of death (n = 8), and acute illness 9 (n=1)

Baseline: Mental Status Questionnaire: Validation group = 12.1, Control group = 14.4
Data Used
 Mental Status Questionnaire
 Minimal Social Behavior Scale
 Philadelphia Geriatric Center Morale Scale
Group 1 N= 12
 No treatment with
Group 2 N= 6
Validation Therapy with - Were randomized to the validation therapy group but did not attend most sessions because of episodic acute illness or extremely disruptive behaviour during the meeting
Group 3 N= 9
Validation Therapy with - Twice a week for 9 months. Subjects attended most sessions
Study Quality: 1+
SPECTOR2003
Study Type: RCT (individual)
Type of Analysis: Intention to treat
Blindness: Single blind
Duration (days): Mean 42

Setting: Multi-centre: 23 centres (18 residential homes, 5 day centres)
Info on Screening Process: No people screened = 292
n= 201
Age: Mean 85
Sex: 43 males 158 females
:
Diagnosis:
 100% Unspecified dementia by DSM IV
 :
 :
Exclusions: Exclusions: did not meet DSM-IV criteria; MMSE <10, >24; not able to communicate; not able to see or hear well enough to participate; major physical illness or disability; diagnosis of learning disabilities
Data Used
 Behaviour Rating Scale (CAPE)
RAID
QoL-AD
 Clinical Dementia Rating Scale
ADAS-Cog
MMSE
 Cornell Scale for Depression in Dementia
 Holden Communication Scale
Group 1 N= 115
 Cognitive Stimulation with - 14 sessions, for 45 minutes, twice a week over 7 weeks. Topics included money, word ames, the present day and famous faces. RO board displaying both personal and orientation information. Included elements of reminiscence, and multisensory stimulation
Group 2 N= 86
Standard Care with - For most residential homes this consisted of doing nothing. For other centres standard care included games such as bingo, music and singing, arts and crafts, and activity groups
Study Quality: 1++
THORGRIMSEN2002
Study Type: RCT (individual)

Study Description: Randomised using sealed envelopes.

Blindness: Single blind
Duration (days): Mean 126

Setting: Sessions conducted by Age
Exchange, London, UK. Participants lived in the community.
Info on Screening Process: Information not provided.
n= 11
Age: Mean 77
Sex: 5 males 6 females
:
Diagnosis:
 100% Unspecified dementia
 :
 :
Data Used
 Behaviour Rating Scale (CAPE)
QoL-AD
MMSE
Group 1 N= 4
 Control with
Group 2 N= 7
Reminiscence Therapy with - 18 weekly session based on the standardised manual Reminiscing with People with Dementia - A Handbook for Carers. Slides, photos, music, dance, dramatising memories were all used as tools.
Study Quality 1+
TOSELAND1997
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 365

Setting: 4 nursing homes in USA
Info on Screening Process: No. people screened = 126, excluded: 38; reasons: 33 severe dementia, 2 didn’t have clear dementia diagnosis, 2 discharged before groups began, 1 refused to attend
n= 88
Age: Mean 88
Sex: 22 males 66 females
:
Diagnosis:
 100% Unspecified dementia
 :
 :
Exclusions: 22 drop outs - 18 died, 2 deteriorating health, 2 refused to continue
 Notes: Clinical diagnosis obtained from their medical records
Baseline: MOSES: self care - validation = 16.54, social contact = 16.09, usual care = 15.70; disorientation - validation = 15.68, social contact = 16.09, usual care = 17.91, depression - validation = 10.64, social contact = 7.73, usual care = 8.78; irritation - validation = 5.36, social contact = 5.64, usual care = 5.22; withdrawal - validation = 14.05, social contact = 13.05, usual care = 14.43
Data Used
 Cohen-Mansfield Agitation Inventory Score
MOSES
Group 1 N= 31
Validation Therapy with - Beginning of session foster warm greetings, holding hands, singing songs. Second segment: reminiscing about past events related to topic of interest. Third segment: activity e.g. sing-along, poetry reading. Fourth segment: refreshments and goodbyes
Group 2 N= 28
Standard Care with - Continued to participate in regular social and recreational program offered by nursing home
Group 3 N= 29
 Active control with - Following a manual containing 54 activities in 8 categories: music, art, literature, writing, dance/exercise, holiday and event planning, discussion, other activites
Study Quality: 1+
WALLIS1983
Study Type: RCT (individual)

Blindness: Single blind
Duration (days): Mean 90
Followup: 1 month after treatment ended

Setting: 6 wards in High Royds hospital, Yorkshire
Info on Screening Process: Information not provided
n= 38
Age: Mean 72 Range 38–95
Sex: 25 males 13 females
:
Diagnosis:

Exclusions: Exclusions: not long stay resident at the ward, not demented and or not withdrawn, willing or able to attend occupational therapy or industrial therapy, not capable of some meaningful communication, blind

All persons with < 20% attendance (n = 22) reasons were: death (6), physical illness (8), refusal (5), could never be found (2), visitors every day (1)
 Notes: Participants diagnosed as either functional (n =19) or organic (n=19) - the functional group were comprised of people with schizophrenia and affective disorders (n= 19)
Baseline: Chrichton: Reality Orientation group: = 57.4; Control: = 52.2
Data Used
 RCPhysicians’ mental scale for the elderly
 Chrichton Scale
Notes: Used a version of the Chrichton modified by Woods (1979)
Group 1 N= 20
 Active control with - Duration: half an hour daily 5 days a week for 3 months. Variety of group and individual activities offered each day. Each patient choses their activity and groups subdivided according to this choice.
Group 2 N= 18
 Reality Orientation with - Duration: half an hour daily for 5 days a week for 3 months. Repetition of information on orientation in time and place, names of persons present and comments on immediate surroundings, the weather and names and uses of everyday objects.
Study Quality: 1+
WOODS1979
Study Type: RCT (individual)

Study Description: randomised to reality orientation or active control, also controls from another home for the elderly (these controls not randomised therefore not inc

Blindness: Single blind
Duration (days):
Followup: 20 weeks

Setting: Residents at homes for the elderly mentally infirm
Info on Screening Process: Information not provided
n= 14
Age: Mean 77 Range 61–90
Sex: 2 males 12 females
:
Diagnosis:

Exclusions: <60 years old, memory quotient >70 Wechsler Memory Scale, not disorientated, could not sufficiently complete psychological tests, very deaf, very restless
Data Used
 WMS-R
 Chrichton Scale
Group 1 N= 4
 No treatment with - Residents from another nursing home (not randomised)
Group 2 N= 5
 Reality Orientation with - 5 days a week, for 30 mins, led by care staff in a room equipped with blackboard, calendar, clock, scrap books etc. A daily personal diary entry of basic information followed by various group activities e.g. spelling games, dominoes, simplified bingo
Group 3 N= 5
 Active control with - Run as a discussion group with staff encouraging each resident to participate. RO materials were not used but sessions occasionally closed with a game of dominoes
Study Quality: 1+

From: APPENDIX 15, INCLUDED/EXCLUDED STUDY INFORMATION TABLES FOR QUANTITATIVE REVIEWS

Cover of Dementia
Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care.
NICE Clinical Guidelines, No. 42.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2007.
© NCCMH. All rights reserved.

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