Despite some positive findings, the inaccurate definitions of CT, inadequate sample sizes, unclear randomization methods, incomplete datasets at follow-up and multiple testing may have inflated the results in many trials. Future high quality RCTs with appropriate classification and specification of cognitive interventions are necessary to confirm CT as an effective treatment option in Alzheimer's disease.

Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia.

Introduction: Evidence is unclear whether cognitive training (CT) has efficacy in patients with dementia. We present the recruitment and baseline findings of a carefully designed Finnish cognitive training (FINCOG) trial exploring the effectiveness of CT among community-dwelling older persons with mild-tomoderate dementia. Methods: Participants were recruited from adult day care centres in Helsinki, Finland, and randomised into two groups: (1) day care with systematic CT twice a week for 12 weeks (n = 76) and (2) day care as usual (n = 71). Demographics, diagnoses and drug use were retrieved from medical records, and baseline cognition, functioning, health-related quality of life (HRQoL) and psychological well-being were assessed. A subgroup of participants was planned to undergo functional magnetic resonance imaging (fMRI) to measure changes in brain activity. Feedback from those attending CT was collected. Primary trial outcomes will be participants' cognition and HRQoL. Results: The mean (SD) age of the randomised participants was 83.1 (5.4) years, 72% were female and 37% at a moderate stage of dementia. The intervention and control groups were comparable at baseline. Compliance with CT was good, with a mean attendance of 22/24 sessions. General subjective gain was achieved by three-fourths of the feedback respondents. However, the fMRI was not feasible in this patient group. Conclusions: We successfully randomised 147 persons with mild-to-moderate dementia in the FINCOG trial. The feedback from participants in cognitive intervention was favourable. The trial will provide important information on the effects of CT in patients with dementia. Trial registration: ACTRN12614000976684.