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Goal-oriented Cognitive Rehabilitation in Early-stage Alzheimer’s and Related Dementias: Multi-centre Single-blind Randomised Controlled Trial (GREAT)

The GREAT trial was a large randomised controlled trial funded by the National Institute for Health Research, conducted in eight centres throughout England and Wales, which aimed to provide definitive evidence about the effectiveness and cost-effectiveness of goal-oriented cognitive rehabilitation for people with early-stage Alzheimer’s disease, vascular, or mixed dementia and their carers.

In GREAT, the cognitive rehabilitation therapy involved 10 home-based sessions with a therapist over three months, followed by four maintenance sessions over the following six months. Over the course of the 10 weekly sessions, participants with dementia  worked in collaboration with a therapist to address up to three  personal rehabilitation goals, where possible supported by a family  carer. They also explored ways of managing anxiety and stress and improving concentration, and reviewed and improved on existing coping strategies.

There were 475 participants with dementia, each with a care partner, included  in the trial, and 427 participants (90%) completed the trial.

Cognitive rehabilitation was found to be effective in enabling people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy sessions.

Key publication to date: Protocol (open access), Trial findings

We are currently working with NHS Trusts, Councils and private providers on implementing GREAT Cognitive Rehabilitation into dementia care and learning how to support wider roll out in future. This is part of the GREAT into Practice project funded by Alzheimer's Society.

Visit the GREAT into Practice website