The effectiveness of reality orientation therapy (ROT) carried on over a period of 24 weeks was evaluated. Thirteen institutionalized elderly subjects with cognitive disturbances (Mini Mental State score between 18 and 25) took part in the study; 6 subjects formed the control group. The assessment instruments were the Clifton Assessment Schedule and the Multidimensional Observation Scale for Elderly Subjects. Results suggest that reality orientation techniques can positively interfere with the cognitive performance and the improvement is correlated with the patient's social feeling.