Management of functional disabilities in dementia
Research type
Research Study
Full title
Management of functional disabilities in dementia: characterisation, non-pharmacological interventions and family carer skills
IRAS ID
165454
Contact name
Eneida Mioshi
Contact email
Sponsor organisation
Cambridge and Peterborough Foundation Trust and University of Cambridge
Duration of Study in the UK
3 years, 11 months, 27 days
Research summary
There are 850,000 people with dementia in the UK, many living in the community supported by unpaid family carers. As well as causing decline in congitive functions such as memory, planning and decision-making, dementia can impact on the person's ability to undertake activities of daily living (ADLs), with significant financial and emotional costs to both patients and caregivers. Difficulties with ADLs are compounded by behavioural and psychological symptoms of dementia (BPSD), including disinhibition, perseveration or apathy. BPSD are associated with reduced quality of life for both the PWD and their caregiver, more time spent care-giving, higher care costs, greater risk for nursing home placement / mortality and high levels of distress and depressive symptoms in carers. Results of pharmacological treatment trials to manage BPSD and improve function have been disappointing, hence the urgent need for evidence-based non-pharmacological interventions.
The present study will evaluate the impact of two such treatments:
1. TAP: a tailored activity programme delivered in up to 8 sessions with an occupational therapist over 4 months. The occupational therapist's time is funded by the trial. The PWD's functional cognition and past/present interests are assessed, and caregivers are supported to deliver a programme of activities designed to match the PWD's abilities, developing skills in realistic goal setting, environmental modification to support activity and communication strategies.2. APTITUDE: a psychoeducation group for caregivers, consisting of 15 weekly 2-hour sessions focussing on cognitive appraisal and coping strategies.
Both interventions are additions to standard care. It is hypothesised that both interventions will lead to a reduction in time spent caring and improved carer skills compared with the control group. TAP will increase patient engagement in activities, particularly in the later disease stages, while APTITUDE will reduce the impact of challenging behaviours on carers, with greatest reduction in the early stages of dementia.
REC name
London - Queen Square Research Ethics Committee
REC reference
15/LO/0432
Date of REC Opinion
7 May 2015
REC opinion
Further Information Favourable Opinion