Journal article
Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial
Journal of the American Geriatrics Society (JAGS), v 66(2), pp 339-345
01 Feb 2018
PMID: 29192967
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background/ObjectivesDementia-related behavioral symptoms and functional dependence result in poor quality of life for persons with dementia and their caregivers. The goal was to determine whether a home-based activity program (Tailored Activity Program; TAP-VA) would reduce behavioral symptoms and functional dependence of veterans with dementia and caregiver burden.
DesignSingle-blind (interviewer), parallel, randomized, controlled trial (Clinicaltrials.gov: NCT01357564).
SettingVeteran's homes.
ParticipantsVeterans with dementia and their family caregivers (N = 160 dyads).
InterventionDyads in TAP-VA underwent 8 sessions with occupational therapists to customize activities to the interests and abilities of the veterans and educate their caregivers about dementia and use of customized activity. Caregivers assigned to attention control received up to 8 telephone-based dementia education sessions with a research team member.
MeasurementsPrimary outcomes included number of behaviors and frequency of their occurrence multiplied by severity of occurrence; secondary outcomes were functional dependence, pain, emotional well-being, caregiver burden (time spent caregiving, upset with behaviors) and affect at 4 (primary endpoint) and 8 months.
ResultsOf 160 dyads (n = 76 TAP-VA; n = 84 control), 111 completed 4-month interviews (n = 51 TAP-VA; n = 60 control), and 103 completed 8-month interviews (n = 50 TAP-VA; n = 53 control). At 4 months, compared to controls, the TAP-VA group showed reductions in number (difference in mean change from baseline = -0.68, 95% CI = -1.23 to -0.13) and frequency by severity (-24.3, 95% CI = -45.6 to -3.1) of behavioral symptoms, number of activities needing assistance with (-0.80, 95% CI = -1.41 to -0.20), functional dependence level (4.09, 95% CI = 1.06, 7.13), and pain (-1.18, 95% CI = -2.10 to -0.26). Caregivers of veterans in TAP-VA reported less behavior-related distress. Benefits did not extend to 8 months.
ConclusionTAP-VA had positive immediate effects and no adverse events. Because TAP-VA reduces behavioral symptoms, slows functional dependence, and alleviates pain and caregiver distress, it is a viable treatment option for families.
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Details
- Title
- Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial
- Creators
- Laura N. Gitlin - Johns Hopkins UniversityPaul Arthur - North Florida/South Georgia Veterans Health SystemCatherine Piersol - Thomas Jefferson UniversityVirginia Hessels - North Florida/South Georgia Veterans Health SystemSamuel S. Wu - University of FloridaYunfeng Dai - University of FloridaWilliam C. Mann - University of Florida
- Publication Details
- Journal of the American Geriatrics Society (JAGS), v 66(2), pp 339-345
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- VA-IIR11-119 / Veterans Administration Health Services Research and Development Service
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University
- Web of Science ID
- WOS:000424907900021
- Scopus ID
- 2-s2.0-85041945217
- Other Identifier
- 991020112126704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Geriatrics & Gerontology
- Gerontology