Journal article
Feasibility of the tailored activity program to bridge hospital and community care for people living with dementia and behavioral disorders: The "Continu-A-Mente" project
BMC geriatrics, Forthcoming
07 Mar 2026
PMID: 41792629
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Abstract
Background
The Tailored Activity Program (TAP) effectively manages Behavioral and Psychological Symptoms of Dementia (BPSD), yet its feasibility across the hospital-to-home care continuum for people living with dementia (PLwD) has not been tested.
Objective
To assess the feasibility of TAP-Continu-A-Mente intervention for managing BPSD in PLwD transitioning from hospital to home, either following a short-stay observation or a memory clinic evaluation. Secondary aims were to evaluate changes in PLwD BPSD, caregiver distress and sense of competence, healthcare use, dyad satisfaction.
Methods
This single-arm interventional feasibility study enrolled 50 dyads (PLwD and caregivers) at IRCCS San Gerardo Hospital (Monza, Italy). PLwD inclusion criteria were age ≥65, dementia diagnosis, Neuropsychiatric Inventory (NPI) ≥6 in at least one item, independence in at least two basic activities of daily living, fluency in Italian. The intervention consisted of eight sessions over three months (two in hospital and six at home) delivered by occupational therapists. The primary outcome was the proportion of dyads completing the program (dyad retention). Secondary outcomes, assessed at baseline and four months, included NPI, Clinical Frailty Scale (CFS), motor-functional status (Katz Index, TUG), caregiver self-efficacy (SCQ), and dyad satisfaction.
Results
PLwD had a median age of 81 (Q1–Q3: 77–86), and 52% were female. Patient baseline median CFS was 6 (Q1–Q3: 6–7), and 78% received ≥12 hours/day of caregiver assistance. Caregivers were mostly female (76%) with a median age of 59 (Q1–Q3: 55.5–74). Dyad retention was 84% (42/50), with dropouts mainly older females. Among completers, NPI total scores decreased at follow-up (frequency x severity 42.5 vs 20.5, and caregiver distress 21 vs 14; p < 0.001), while SCQ score increased (52 vs 65; p < 0.001). CNS-active medication use increased overall, from 1 to 2. Katz Index declined from 4 to 3, whereas TUG remained stable (15.5 vs 16.3). No institutionalizations occurred, and one hospitalization was recorded. More than half of patients and caregivers rated their experience as 5/5.
Conclusions
TAP-Continu-A-Mente was a feasible hospital-to-home model of care for PLwD with BPSD. The observed reductions in NPI scores should be considered hypothesis-generating, warranting further investigation.
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Details
- Title
- Feasibility of the tailored activity program to bridge hospital and community care for people living with dementia and behavioral disorders: The "Continu-A-Mente" project
- Creators
- Christian Pozzi (Corresponding Author) - University of Applied Sciences and Arts of Southern SwitzerlandMaria Cristina Ferrara - University of Milano-BicoccaAndrea Staglianò - Azienda Ospedaliera San GerardoClaudia Ballabio - MerMec (Italy)Chiara De Ponti - MerMec (Italy)Laura Antolini - University of Milano-BicoccaStefano Cavalli - University of Applied Sciences and Arts of Southern SwitzerlandLaura N Gitlin - Drexel UniversityGiuseppe Bellelli - University of Milano-Bicocca
- Publication Details
- BMC geriatrics, Forthcoming
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions
- Other Identifier
- 991022167642304721