title: Goal-oriented cognitive rehabilitation in early-stage dementia: study protocol for a multi-centre single-blind randomised controlled trial (GREAT).
abstract: BACKGROUND
  Preliminary evidence suggests that goal-oriented cognitive rehabilitation (CR) may be a clinically effective intervention for people with early-stage Alzheimer's disease, vascular or mixed dementia and their carers. This study aims to establish whether CR is a clinically effective and cost-effective intervention for people with early-stage dementia and their carers.
  
  
  METHODS
  In this multi-centre, single-blind randomised controlled trial, 480 people with early-stage dementia, each with a carer, will be randomised to receive either treatment as usual or cognitive rehabilitation (10 therapy sessions over 3 months, followed by 4 maintenance sessions over 6 months). We will compare the effectiveness of cognitive rehabilitation with that of treatment as usual with regard to improving self-reported and carer-rated goal performance in areas identified as causing concern by people with early-stage dementia; improving quality of life, self-efficacy, mood and cognition of people with early-stage dementia; and reducing stress levels and ameliorating quality of life for carers of participants with early-stage dementia. The incremental cost-effectiveness of goal-oriented cognitive rehabilitation compared to treatment as usual will also be examined.
  
  
  CONCLUSIONS
  If the study confirms the benefits and cost-effectiveness of cognitive rehabilitation, it will be important to examine how the goal-oriented cognitive rehabilitation approach can most effectively be integrated into routine health-care provision. Our aim is to provide training and develop materials to support the implementation of this approach following trial completion.
authors.affiliation: School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, UK. l.clare@bangor.ac.uk
authors.forename: Linda
authors.initials: L
authors.lastname: Clare
authors.forename: Antony
authors.initials: A
authors.lastname: Bayer
authors.forename: Alistair
authors.initials: A
authors.lastname: Burns
authors.forename: Anne
authors.initials: A
authors.lastname: Corbett
authors.forename: Roy
authors.initials: R
authors.lastname: Jones
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.forename: Michael
authors.initials: M
authors.lastname: Kopelman
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kudlicka
authors.forename: Iracema
authors.initials: I
authors.lastname: Leroi
authors.forename: Jan
authors.initials: J
authors.lastname: Oyebode
authors.forename: Jackie
authors.initials: J
authors.lastname: Pool
authors.forename: Bob
authors.initials: B
authors.lastname: Woods
authors.forename: Rhiannon
authors.initials: R
authors.lastname: Whitaker
mesh_terms: D000339:Affect; D017028:Caregivers / Q000523:psychology; D002985:Clinical Protocols; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000191:economics; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D006040:Goals; D017048:Health Care Costs; D006801:Humans; D017060:Patient Satisfaction; D011788:Quality of Life; D012107:Research Design; D020377:Self Efficacy; D016037:Single-Blind Method; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom