Goal-oriented cognitive rehabilitation in early-stage dementia: study protocol for a multi-centre single-blind randomised controlled trial (GREAT)

Trials. 2013 May 27;14:152. doi: 10.1186/1745-6215-14-152.

Abstract

Background: Preliminary evidence suggests that goal-oriented cognitive rehabilitation (CR) may be a clinically effective intervention for people with early-stage Alzheimer's disease, vascular or mixed dementia and their carers. This study aims to establish whether CR is a clinically effective and cost-effective intervention for people with early-stage dementia and their carers.

Methods/design: In this multi-centre, single-blind randomised controlled trial, 480 people with early-stage dementia, each with a carer, will be randomised to receive either treatment as usual or cognitive rehabilitation (10 therapy sessions over 3 months, followed by 4 maintenance sessions over 6 months). We will compare the effectiveness of cognitive rehabilitation with that of treatment as usual with regard to improving self-reported and carer-rated goal performance in areas identified as causing concern by people with early-stage dementia; improving quality of life, self-efficacy, mood and cognition of people with early-stage dementia; and reducing stress levels and ameliorating quality of life for carers of participants with early-stage dementia. The incremental cost-effectiveness of goal-oriented cognitive rehabilitation compared to treatment as usual will also be examined.

Discussion: If the study confirms the benefits and cost-effectiveness of cognitive rehabilitation, it will be important to examine how the goal-oriented cognitive rehabilitation approach can most effectively be integrated into routine health-care provision. Our aim is to provide training and develop materials to support the implementation of this approach following trial completion.

Publication types

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

MeSH terms

  • Affect
  • Caregivers / psychology
  • Clinical Protocols
  • Cognition
  • Cognitive Behavioral Therapy* / economics
  • Cost-Benefit Analysis
  • Dementia / diagnosis
  • Dementia / economics
  • Dementia / psychology
  • Dementia / rehabilitation*
  • Goals*
  • Health Care Costs
  • Humans
  • Patient Satisfaction
  • Quality of Life
  • Research Design*
  • Self Efficacy
  • Single-Blind Method
  • Stress, Psychological / prevention & control
  • Stress, Psychological / psychology
  • Time Factors
  • Treatment Outcome
  • United Kingdom

Associated data

  • ISRCTN/ISRCTN21027481