{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:29:03Z","timestamp":1790947743351,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T00:00:00Z","timestamp":1551398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["11\/15\/04"],"award-info":[{"award-number":["11\/15\/04"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine whether individual goal\u2010oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild\u2010to\u2010moderate dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>Parallel group multicentre single\u2010blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD\u201010 diagnosis of Alzheimer, vascular or mixed dementia, and mild\u2010to\u2010moderate cognitive impairment (Mini\u2010Mental State Examination [MMSE] score\u00a0\u2265\u00a018), and with a family member willing to contribute. Participants allocated to CR received 10 weekly sessions over 3\u00a0months and four maintenance sessions over 6\u00a0months. Participants were followed up 3 and 9\u00a0months post randomisation by blinded researchers. The primary outcome was self\u2010reported goal attainment at 3\u00a0months. Secondary outcomes at 3 and 9\u00a0months included informant\u2010reported goal attainment, quality of life, mood, self\u2010efficacy, and cognition and study partner stress and quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We randomised (1:1) 475 people with dementia; 445 (CR\u00a0=\u00a0281) were included in the intention to treat analysis at 3\u00a0months and 426 (CR\u00a0=\u00a0208) at 9\u00a0months. At 3\u00a0months, there were statistically significant large positive effects for participant\u2010rated goal attainment (d\u00a0=\u00a00.97; 95% CI, 0.75\u20101.19), corroborated by informant ratings (d\u00a0=\u00a01.11; 95% CI, 0.89\u20101.34). These effects were maintained at 9\u00a0months for both participant (d\u00a0=\u00a00.94; 95% CI, 0.71\u20101.17) and informant (d\u00a0=\u00a00.96; 95% CI, 0.73\u20101.2) ratings. The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CR enables people with early\u2010stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5076","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T13:35:35Z","timestamp":1549460135000},"page":"709-721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":139,"title":["Individual goal\u2010oriented cognitive rehabilitation to improve everyday functioning for people with early\u2010stage dementia: A multicentre randomised controlled trial (the GREAT trial)"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3989-5318","authenticated-orcid":false,"given":"Linda","family":"Clare","sequence":"first","affiliation":[{"name":"Centre for Research in Ageing and Cognitive Health University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6955-9043","authenticated-orcid":false,"given":"Aleksandra","family":"Kudlicka","sequence":"additional","affiliation":[{"name":"Centre for Research in Ageing and Cognitive Health University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0263-8740","authenticated-orcid":false,"given":"Jan R.","family":"Oyebode","sequence":"additional","affiliation":[{"name":"School of Dementia Studies University of Bradford  Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7953-5985","authenticated-orcid":false,"given":"Roy W.","family":"Jones","sequence":"additional","affiliation":[{"name":"The RICE Centre Royal United Hospital  Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7514-248X","authenticated-orcid":false,"given":"Antony","family":"Bayer","sequence":"additional","affiliation":[{"name":"Division of Population Medicine, Cardiff University University Llandough Hospital  Penarth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1822-3643","authenticated-orcid":false,"given":"Iracema","family":"Leroi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Experimental Psychology, Jean McFarlane Building University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0526-3160","authenticated-orcid":false,"given":"Michael","family":"Kopelman","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, St Thomas' Hospital King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2728-996X","authenticated-orcid":false,"given":"Ian A.","family":"James","sequence":"additional","affiliation":[{"name":"Centre of the Health of the Elderly Northumberland Tyne and Wear NHS Foundation Trust  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6950-5451","authenticated-orcid":false,"given":"Alison","family":"Culverwell","sequence":"additional","affiliation":[{"name":"Kent and Medway NHS Partnership Trust St Martin's Hospital  Canterbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-0753","authenticated-orcid":false,"given":"Jackie","family":"Pool","sequence":"additional","affiliation":[{"name":"Dementia Pal Ltd.  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