The Clinical Trial
CST was designed through systematically reviewing the literature on the main non-pharmacological therapies for dementia (2, 3). The most effective elements of the different therapies were combined to create the CST programme, which was modified following a pilot study (4). CST was then evaluated as a multi-centre randomised controlled trial (RCT) in 23 centres (residential homes and day centres) (1).
The 201 participants with a diagnosis of dementia were randomly allocated to either CST groups or a 'no treatment' control condition. The results of the trial showed that CST led to significant benefits in people's cognitive functioning, as measured by the Mini-Mental State Examination (MMSE) and the ADAS-COG. These tests primarily investigate memory and orientation, but also language and visuospatial abilities. Because these outcome measures are used in the dementia drug trials, direct comparisons could be made.
Analyses suggested that for larger improvements in cognition, CST is equally effective as several dementia drugs. Further, CST led to significant improvements in quality of life, as rated by the participants themselves using the QoL-AD. There were no reported side-effects of CST.