Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial

Br J Psychiatry. 2003 Sep:183:248-54. doi: 10.1192/bjp.183.3.248.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinesterase Inhibitors / therapeutic use
  • Cognition
  • Cognitive Behavioral Therapy / methods*
  • Communication
  • Dementia / drug therapy
  • Dementia / psychology
  • Dementia / therapy*
  • Evidence-Based Medicine / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology
  • Sex Factors
  • Treatment Outcome


  • Cholinesterase Inhibitors