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Individual Cognitive Stimulation Therapy for dementia (iCST): study protocol for a randomized controlled trial

Martin Orrell1, Lauren A Yates1*, Alistair Burns2, Ian Russell3, Robert T Woods4, Zoe Hoare5, Esme Moniz-Cook6, Catherine Henderson7, Martin Knapp78, Aimee Spector9 and Vasiliki Orgeta1

Author Affiliations

1 Mental Health Sciences Unit, University College, London, UK

2 Department of Old Age Psychiatry, University of Manchester, Manchester, UK

3 School of Medicine, Swansea University, Swansea, UK

4 Dementia Services Development Centre Wales, Bangor University, Bangor, UK

5 North Wales Organisation for Randomised Trials in Health (& Social Care), University of Bangor, Bangor, UK

6 Institute of Rehabilitation, University of Hull, Hull, UK

7 London School of Economics and Political Science, London, UK

8 Institute of Psychiatry at King’s College London, London, UK

9 Department of Clinical Psychology, University College London, London, UK

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Trials 2012, 13:172  doi:10.1186/1745-6215-13-172

Published: 22 September 2012

Abstract

Background

Improving the quality of care for people with dementia and their carers has become a national priority in many countries. Cognitive Stimulation Therapy (CST) groups can be beneficial in improving cognition and quality of life for people with dementia. The aim of the current study is to develop and evaluate a home-based individual Cognitive Stimulation Therapy (iCST) programme for people with dementia which can be delivered by their family carer.

Methods

This multi-centre, pragmatic randomised controlled trial (RCT) will compare the effectiveness and cost-effectiveness of iCST for people with dementia with a treatment as usual control group. The intervention consists of iCST sessions delivered by a carer for 30 minutes, 3 times a week over 25 weeks.

For people with dementia the primary outcome measures are cognition assessed by the ADAS-Cog, and quality of life assessed by QoL-AD. For carers, quality of life using the SF-12 is the primary outcome measure. Using a 5% significance level, comparison of 306 participants will yield 80% power to detect an effect size of 0.35 for cognition as measured by the ADAS-Cog, and quality of life as measured by the QoL-AD. Quality of life for the carer will be measured using the SF-12. The trial will include a cost-effectiveness analysis from a public sector perspective.

Discussion

The UK Department of Health has recently stressed that improving access to psychological therapies is a national priority, but many people with dementia are unable to access psychological interventions. The development of a home-based individual version of CST will provide an easy to use, widely available therapy package that will be evaluated for effectiveness and cost-effectiveness in a multi centre RCT.