Dementia, Depression
Conditions
Keywords
Dementia, Depression, Burden of care, Psychosocial intervention, Family home care
Brief summary
Dementia is one of the most common and devastating diseases in the elderly, it leads to helplessness, no cure exists and therefore care is necessary to provide. The care is associated with a great burden for the family carers and expensive for the society when residential care is required. The purpose of this study is to improve knowledge on how to provide better care for both the patients and their family carers, the investigators want to carry out a controlled trial using a rather cheap form of intervention, a multidimensional support program - an 18 months randomized controlled intervention study.
Detailed description
The 230 dyads of families, patients and carers, will be recruited from 18 municipalities, 18 from each municipality with at least 15 000 inhabitants. Only home dwelling patients and carers with at least weekly face-to face contact with the patient will be included. The patients will be recruited both from memory clinics, outpatients clinics in geriatric medicine and old age psychiatry and from home nurse districts. The patients should have a diagnosis of dementia according to ICD-10 criteria, have a score on Mini Mental State Examination of at least 15 points and have capacity to give informant consent to participation in the study. The carers should score at least five on the Relatives' Stress Scale. 115 family, control group, will receive care 'as usual' in the municipalities. The 115 family intervention group will have a duration of 18 months consisting individual counselling, education about dementia, problem-solving groups and ad-hoc counselling when needed. Effects will be measured at three levels, at patient level, at carer level and at societal level. Measurements will take place at baseline, after three, six, 12 and 18 months. At patient level, the Cornell scale will be used as the primary outcome. At carer's level, the primary outcome is the Relatives' Stress Scale. For the outcome on the social level Resource Utilisation in Dementia will be used. The carers will be contacted every year up till five years after the intervention ended to give information about their own physical and psychological health and the patient's use of formal help such as day care centre, respite care and permanent nursing home placement.
Interventions
BEHAVIORALA multidimensional support program
Counseling, education and problem-solving in support group, ad hoc counseling
Sponsors
The Research Council of Norway
Kavli Research Center for Ageing and Dementia
Norwegian Centre for Ageing and Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Home dwelling patients and carers with at least weekly face-to face contact with the patients * The patients should have a diagnosis of dementia according to ISD-10 criteria * A Mini Mental State Examination (MMSE)og at least 15 point. * Have capacity to give informant consent to participation in the study * The carers should score at least five on the Relatives'Stress Scale(RSS)
Exclusion criteria
* Result from the inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Differences in level of depression between groups | After 12 months | Cornell scala for depression will be used to measure depression among the person with dementia and Geriatric Depression Scale (GDS) will be used for the carer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in stress among carers | after 12 months | Relatives Stress Scale(RSS) will be used |
| Neuropsychiatric Inventory (NPI) | after 12 months | — |
| Quality of life among people with dementia and carers | after 12 months | The Quality of life in Alzheimer's disease (QOL-AD) |
| Measures function in activities of daily living | after 12 months | Lawton & Brody Instrumental and Performance activities daily living scale (IADL and PADL) |
| measure expressed emotion | after 12 months | Using Felt Expressed Emotion Rating Scale (FEERS) |
| Resource Utilisation in Dementia | after 12 months | Resource Utilisation in Dementia (RUD Lite) instrument (Wimo, 1998) which contains questions concerning use of community care services, type of accommodation, the employment status of the patient and primary caregiver, medical and informal care. |
| Mini mental status (MMSE) | after 12 months | — |
| Differences in level of depression between groups | after 24 months | Cornell scala for depression will be used to measure depression among the person with dementia and Geriatric Depression Scale (GDS) will be used for the carer. |
| Change in stress among carers(RSS) | after 24 months | — |
| Quality of life among people with dementia and carers(QOL-AD) | after 24 months | — |
| Locus of control among carers | after 12 months | — |
Countries
Norway
Outcome results
None listed