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dc.contributor.authorClare, L.*
dc.contributor.authorKudlicka, A.*
dc.contributor.authorOyebode, Jan R.*
dc.contributor.authorJones, R.W.*
dc.contributor.authorBayer, A.*
dc.contributor.authorLeroi, I.*
dc.contributor.authorKopelman, M.*
dc.contributor.authorJames, I.A.*
dc.contributor.authorCulverwell, A.*
dc.contributor.authorPool, J.*
dc.contributor.authorBrand, A.*
dc.contributor.authorHenderson, C.*
dc.contributor.authorHoare, Z.*
dc.contributor.authorKnapp, M.*
dc.contributor.authorWoods, B.*
dc.date.accessioned2019-03-12T15:30:46Z
dc.date.available2019-03-12T15:30:46Z
dc.date.issued2019
dc.identifier.citationClare L, Kudlicka A, Oyebode JR et al (2019) Individual goal-oriented cognitive rehabilitation to improve everyday functioning for people with early-stage dementia: a multi-centre randomised controlled trial (the GREAT trial). Cognitive rehabilitation in early-stage dementia: the GREAT trial. International Journal of Geriatric Psychiatry. 34(5): 702-721.en_US
dc.identifier.urihttp://hdl.handle.net/10454/16887
dc.descriptionYesen_US
dc.description.abstractObjectives: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia. Design and methods: Parallel group multi-centre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer’s, vascular or mixed dementia and mild-to-moderate cognitive impairment (MMSE score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received ten weekly sessions over three months and four maintenance sessions over six months. Participants were followed up three and nine months post-randomisation by blinded researchers. The primary outcome was self-reported goal attainment at three months. Secondary outcomes at three and nine months included informant-reported goal attainment, quality of life, mood, self-efficacy, and cognition, and study partner stress and quality of life. Results: We randomised (1:1) 475 people with dementia; 445 (CR=281) were included in the intention to treat analysis at three months, and 426 (CR=208) at nine months. At three months there were statistically-significant large positive effects for participant-rated goal attainment (d=0.97, 95% CI 0.75 to 1.19), corroborated by informant ratings (d=1.11, 0.89 to 1.34). These effects were maintained at nine months for both participant (d=0.94, 0.71 to 1.17) and informant ratings (d=0.96, 0.73 to 1.2). The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes. Conclusions: Cognitive rehabilitation enables people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy.en_US
dc.description.sponsorshipNational Institute for Health, Health Technology Assessment Programme, Grant/Award Number: 11/15/04en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1002/gps.5076en_US
dc.rights© 2019 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.en_US
dc.subjectActivities of daily livingen_US
dc.subjectAlzheimer diseaseen_US
dc.subjectDisabilityen_US
dc.subjectGoal-settingen_US
dc.subjectNonpharmacological interventionen_US
dc.subjectPerson-centreden_US
dc.subjectProblem-solvingen_US
dc.subjectReablementen_US
dc.subjectVascular dementiaen_US
dc.titleIndividual goal-oriented cognitive rehabilitation to improve everyday functioning for people with early-stage dementia: a multi-centre randomised controlled trial (the GREAT trial)en_US
dc.status.refereedYesen_US
dc.date.Accepted2019-01-28
dc.date.application2019-02-06
dc.typeArticleen_US
dc.type.versionPublished versionen_US
refterms.dateFOA2019-03-12T15:30:46Z


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