Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial
Martin Orrell, Elisa Aguirre, Aimee Spector, Zoe Hoare, Robert T. Woods, Amy Streater, Helen Donovan, Juanita Hoe, Martin Knapp, Christopher Whitaker, Ian Russell
  • Declaration of interest

    Royalties from the sale of the Making a Difference manuals are paid to the Dementia Services Development Centre, Bangor University.



There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.


To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).


The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).


For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer’s Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).


Continuing CST improves quality of life; and improves cognition for those taking AChEIs.


  • Funding

    Maintenance Cognitive Stimulation Programme (ISRCTN26286067) is part of the Support at Home - Interventions to Enhance Life in Dementia (SHIELD) project (Application No. RP-PG-0606-1083) awarded to M.O. (University College London (UCL)/North East London Foundation Trust), based in North East London Foundation Trust (study sponsor), and funded by the National Institute of Health Research (NIHR) Programme Grants for Applied Research funding scheme. Other grant holders include R.T.W. (Bangor), David Challis (Manchester), Esme Moniz-Cook (Hull), I.R. (Swansea), M.K. (LSE) and Georgina Charlesworth (UCL). This article presents independent research commissioned by the NIHR under its Programme Grants for Applied Research scheme (RP-PG-060-1083). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR or the Department of Health. The NIHR Programme Grant for Applied Research scheme monitors progress of the programme RP-PG-060-1083 through regular reports. The NIHR encourages grant-holders to seek external peer-reviewed publication.

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