Paddick 2017.

Study characteristics
Methods	Stepped wedge design
Participants	N = 34 (29F/5M) Dementia according to DSM‐IV criteria None receiving AChEI medication Mean Clinical Dementia Rating 1.65 (range 1‐2) Median age 80 (IQR 76.5‐85.3) Community
Interventions	Cognitive stimulation groups (N = 16) Wait‐list controls (N = 18)
Outcomes	Cognition: ADAS‐Cog Quality of life: World Health Organization Quality of Life assessment (WHOQOL) Mood: Hospital Anxiety & Depression Scales ADL: World Health Organization Disability Assessment Schedule (WHODAS 2.0) Behaviour problems: NPI Caregiver outcomes: WHOQOL; Zarit Burden Inventory; Hospital Anxiety & Depression Scales; NPI Caregiver distress
Notes	45 minutes, twice a week, for 7 weeks Relevant comparison was at assessment 8 weeks after baseline, where those who received cognition stimulation could be compared with the wait‐list controls, who had received treatment‐as‐usual. Only ADAS‐Cog data were available for this comparison.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Cluster‐randomised. Simple randomisation with random number generator
Allocation concealment (selection bias)	Low risk	Randomisation carried out by independent statistician, blinded to participant allocation
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Outcome assessors were blind to group allocation and did not deliver the CST sessions; participants reminded not to disclose
Incomplete outcome data (attrition bias) All outcomes	Low risk	Intention‐to‐treat protocol ‐ no attrition in relation to comparison of immediate and delayed start groups
Selective reporting (reporting bias)	High risk	Although all outcome measures were reported for the comparison of interest (between immediate and delayed start CST groups), only data on ADAS‐Cog provided
Other bias ‐ training and supervision	Low risk	Facilitators received training on CST in the UK and had been involved in the adaptation and pilot of adapted CST for Sub‐Saharan Africa.
Other bias ‐ treatment manual	Low risk	Published manual ‐ adapted from CST manual