ABSTRACT
Psychological treatments for dementia, such as reality orientation, have been in use for nearly half a century (Taulbee & Folsom, 1966). Despite their longevity, their effects remain open to question and many studies have been either small, of poor methodological quality, or both (Orrell & Woods, 1996). Reality orientation operates through the presentation and repetition of orientation information, either throughout the day {‘24-hour’) or in groups meeting on a regular basis to engage in orientation-related activities (‘classroom’) (Brook et al, 1975). A recent Cochrane review found that reality orientation was associated with significant improvements in both cognition and behaviour, but also identified a need for large, well-designed, multi-centre trials (Spector et al, 1998, 2000). The results of the Cochrane review were used to develop a programme of evidence-based therapy focused on cognitive stimulation (Spector e t al, 2001). The cognitive stimulation therapy was piloted in three care homes and one day centre, leading to improvements in cognition and depression for people participating in the programme compared with the control group (Spector et al, 2001). The aim of the study reported here was to evaluate the effects of cognitive stimulation therapy groups on cognition and quality of life for people with dementia, in a single-blind, multi-centre, randomised controlled trial (RCT).
