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Improving Self-Care of Behavioral Variant Frontotemporal Dementia Caregivers

Efficacy of a Virtual Intervention for Informal Caregivers of Adults With Frontotemporal Dementia

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04686266
Acronym
ViCCY
Enrollment
43
Registered
2020-12-28
Start date
2020-12-16
Completion date
2021-11-03
Last updated
2025-02-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Behavioral Variant of Frontotemporal Dementia, Caregiver Stress Syndrome

Brief summary

The research study is being conducted to evaluate the efficacy of a virtual support intervention to reduce stress and poor self-care for caregivers of persons with behavioral variant Frontotemporal Degeneration (bvFTD) compared to receiving health information alone.

Detailed description

Informal caregivers of persons with Frontotemporal degeneration (FTD) are an understudied population with unique needs. FTD is a common cause of young-onset dementia with no known cure. Behavioral variant FTD (bvFTD) is the most common of the FTD syndromes and involves a progressive disorder of emotional regulation and personality, and significant impairment in executive function. bvFTD caregivers face unique challenges which are particularly stressful, including young age at which the disorder appears, behavioral symptoms like apathy and disinhibition that are severe and appear early in bvFTD, and the lack of appropriate supportive services. Indeed, numerous studies have demonstrated that stress, depression and burden are higher in FTD caregivers than in any of the other ADRDs, yet caregiver interventions tested in specifically in the FTD population have been limited to a few small studies that focus on education around patient behavior management, not caregiver self-care. The research study is being conducted to evaluate the efficacy of a virtual support intervention to reduce stress and poor self-care for caregivers of persons with behavioral variant Frontotemporal Degeneration (bvFTD) compared to receiving health information alone. 30 caregivers will be randomized 1:1 to a health information: health information + health coaching group. Catered information will be delivered via tablets over 6 months with testing dispersed at baseline, 1 month, 3 months, and 6 months.

Interventions

BEHAVIORALHealth Information + Health Coaching

Virtual Health Coaching for You: The focus of these sessions is helping caregivers take care of themselves. These are virtual health coaching sessions by trained Health Coaches over 6 months with content based on the theoretical framework from our prior research

Sponsors

University of Pennsylvania
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)

Masking description

Investigators and all staff involved in collecting assessment data will be blinded to group assignment until after the data are locked. The Health Coaches providing the intervention and the caregiver participants will not be blinded.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Informal caregiver providing care at least 8 hours/week * Reporting poor self-care on screening (Health Self-Care Neglect Scale, score ≥ 2) * Able to complete the protocol, e.g., adequate vision and hearing, English speaking * Caregiver of a patient diagnosed bvFTD

Exclusion criteria

* Participation in another support randomized, controlled trial * Untreated major psychiatric illness (Use of anti-anxiety/anti-depressant medicines is acceptable and will be adjusted in analysis if group imbalance is identified.) * Caregiver with Cognitive Impairment based on Telephone Interview for Cognitive Status (TICS) score \<25

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in the Self-Care Inventory (SCI)6 months30 items scored 0-100. A higher score indicates better self-care. This theoretically-derived instrument has construct validity. The self-care confidence scale is embedded within this instrument.
Change From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)6 monthsThe FTDRS includes 30 questions covering 7 categories: behavior, outing and shopping, household chores and telephone, finances, medications, meal preparation and eating, and self care and mobility. Each question is scored on a likert scale of never (0) to all the time (2). Higher scores represents more frequent symptoms. The reported scores are the mean/standard deviation for the first 7 questions (Category: Behavior).

Secondary

MeasureTime frameDescription
Change From Baseline in Ways of Coping Questionnaire, Short Form6 monthsThis 42-item questionnaire measures the use of five different coping styles: avoidance, problem-focused, seeking social support, self-blame, and wishful thinking. The original scale has been used widely since developed by Lazarus in 1985. The short version (30 items) uses a 4-point Likert-scale response format (0 = not used to 3 = used a great deal). Scores range from 0-90 with higher scores indicating greater coping. It is reliable (alpha 0.95) and has construct validity. This instrument has been used numerous times in studies with older adult caregivers.
Change From Baseline in Perceived Stress Scale6 monthsThe Perceived Stress Scale is a 14-item instrument that provides a global rating of an individual's belief in the severity and frequency of stressful experiences during the last month. The Perceived Stress Scale includes 14 items designed to assess symptoms of stress and global measures of the degree of stress experienced in the past month. Each item is scored from 0 (never) to 4 (very often), with total sum scores ranging from 0 to 56; higher scores indicate higher perceived stress.
Change From Baseline in Neuropsychiatric Inventory6 monthsCommonly used scale to evaluate 12 common behaviors in dementia including Delusions, Hallucinations, Agitation/Aggression, Depression, Anxiety, Elation/Euphoria, Apathy/Indifference, Disinhibition, Irritability, Aberrant motor behavior, Sleep and Nighttime Behavior Disorders, Appetite and Eating Disorders. Ratings include the frequency of the occurrence of behaviors (1 = occasionally, 2 = often, 3 = frequently, 4 = very frequently), and the level of severity of behaviors (1 = mild, 2 = moderate, 3 = severe). The behavioral domain total score is the product of the frequency score multiplied by the severity score for that behavior. The NPI total score is the sum of all the individual behavioral domains. Scores range from 0-144. Higher scores demonstrate greater symptoms frequency and severity.
Change From Baseline in Zarit Burden Interview (ZBI)6 monthsThe ZBI has been used in numerous informal dementia caregiver studies to capture burden associated with providing care to a loved one. Total scores are summed and a range is provided for little to no burden (0-21) to severe burden (61-88).
Change From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)6 monthsCES-D is a valid and reliable scale for detecting caregiver depression in dementia. The scoring is on a likert scale 0: Rarely or none of the time (less than 1 day), 1: Some or a little of the time (1-2 days), 2: Occasionally or a moderate amount of time (3-4 days), and 3: Most or all of the time (5-7 days). Higher scores represent greater depressive symptoms. Total scores can range 0 to 60. A score equal or above a 16 means a person is at risk for clinical depression.

Countries

United States

Participant flow

Recruitment details

Participants were recruited by clinician referral from the University of Pennsylvania Frontotemporal Degeneration Center between December 2020 to April 2021. The first participant was enrolled in December 2020 and the final was enrolled in April 2021. Data collection began in December 2020 and finished in November 2021.

Pre-assignment details

Of 43 people contacted for recruitment, 8 declined to participate and 4 were ineligible. 31 were randomized to the protocol.

Participants by arm

ArmCount
ViCCY: Health Information + Health Coaching
This group will receive 10 front-loaded sessions of virtual health coaching by trained Health Coaches over 6 months with content based on the theoretical framework our prior research. Sessions are provided using tablets. Initially, sessions are weekly to build the relationship, but the frequency of sessions decreases over time Health Information + Health Coaching: Virtual Health Coaching for You: The focus of these sessions is helping caregivers take care of themselves. These are virtual health coaching sessions by trained Health Coaches over 6 months with content based on the theoretical framework from our prior research
15
Health Information
Caregivers in the Health Information group are asked to spend at least 30 minutes weekly using the computer tablet provided to you by the study team to access recommended websites
15
Total30

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyWithdrawal by Subject01

Baseline characteristics

CharacteristicHealth InformationViCCY: Health Information + Health CoachingTotal
Age, Continuous65.07 years
STANDARD_DEVIATION 9.95
62.80 years
STANDARD_DEVIATION 11.3
63.93 years
STANDARD_DEVIATION 10.52
Clinical Dementia Rating Scale-Frontotemporal Lobar Degeneration (global score)1.70 units on a scale
STANDARD_DEVIATION 0.75
1.82 units on a scale
STANDARD_DEVIATION 0.96
1.77 units on a scale
STANDARD_DEVIATION 0.85
Education of Caregiver (years)
Bachelor's Degree
3 Participants4 Participants7 Participants
Education of Caregiver (years)
Doctoral or Professional Degree
8 Participants8 Participants16 Participants
Education of Caregiver (years)
Grade School
1 Participants0 Participants1 Participants
Education of Caregiver (years)
High School graduate or GED
1 Participants2 Participants3 Participants
Education of Caregiver (years)
Trade School or some college
2 Participants1 Participants3 Participants
Race/Ethnicity, Customized
Race of Caregiver
Asian
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Race of Caregiver
Black or AA
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Race of Caregiver
Multi-Racial
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Race of Caregiver
Other
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Race of Caregiver
White or Caucasian
13 Participants13 Participants26 Participants
Relationship to Patient
Daughter
0 Participants1 Participants1 Participants
Relationship to Patient
Mother
1 Participants0 Participants1 Participants
Relationship to Patient
Other Relative
1 Participants0 Participants1 Participants
Relationship to Patient
Spouse
13 Participants14 Participants27 Participants
Sex: Female, Male
Female
10 Participants12 Participants22 Participants
Sex: Female, Male
Male
5 Participants3 Participants8 Participants
Time as Caregiver (years)4.99 years
STANDARD_DEVIATION 3.26
4.97 years
STANDARD_DEVIATION 2.26
4.98 years
STANDARD_DEVIATION 2.75

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 150 / 15
other
Total, other adverse events
0 / 150 / 15
serious
Total, serious adverse events
0 / 150 / 15

Outcome results

Primary

Change From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)

The FTDRS includes 30 questions covering 7 categories: behavior, outing and shopping, household chores and telephone, finances, medications, meal preparation and eating, and self care and mobility. Each question is scored on a likert scale of never (0) to all the time (2). Higher scores represents more frequent symptoms. The reported scores are the mean/standard deviation for the first 7 questions (Category: Behavior).

Time frame: 6 months

Population: skipped question by participant

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q2- Month 61.53 score on a scaleStandard Deviation 0.64
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q3- Baseline2.14 score on a scaleStandard Deviation 0.77
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q3- Month 62.13 score on a scaleStandard Deviation 0.64
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q4- Baseline1.73 score on a scaleStandard Deviation 0.7
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q4- Month 61.93 score on a scaleStandard Deviation 0.46
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q5- Baseline2.00 score on a scaleStandard Deviation 0.53
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q5- Month 61.93 score on a scaleStandard Deviation 0.59
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q6- Baseline1.73 score on a scaleStandard Deviation 0.8
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q6- Month 61.67 score on a scaleStandard Deviation 0.49
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q7- Baseline2.13 score on a scaleStandard Deviation 0.92
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q1- Baseline1.67 score on a scaleStandard Deviation 0.49
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q1- Month 61.93 score on a scaleStandard Deviation 0.46
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q2- Baseline1.47 score on a scaleStandard Deviation 0.74
ViCCY: Health Information + Health CoachingChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q7- Month 62.00 score on a scaleStandard Deviation 0.76
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q1- Baseline1.67 score on a scaleStandard Deviation 0.49
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q2- Month 61.60 score on a scaleStandard Deviation 0.83
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q6- Baseline1.73 score on a scaleStandard Deviation 0.46
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q3- Baseline2.13 score on a scaleStandard Deviation 0.52
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q2- Baseline1.53 score on a scaleStandard Deviation 0.64
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q3- Month 62.13 score on a scaleStandard Deviation 0.52
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q6- Month 61.87 score on a scaleStandard Deviation 0.74
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q4- Baseline1.80 score on a scaleStandard Deviation 0.56
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q1- Month 61.73 score on a scaleStandard Deviation 0.8
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q4- Month 61.93 score on a scaleStandard Deviation 0.59
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q7- Baseline2.00 score on a scaleStandard Deviation 0.76
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q5- Baseline1.93 score on a scaleStandard Deviation 0.59
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q7- Month 61.93 score on a scaleStandard Deviation 0.8
Health InformationChange From Baseline in Frontotemporal Dementia Rating Scale (FTDRS)Q5- Month 61.93 score on a scaleStandard Deviation 0.8
Primary

Change From Baseline in the Self-Care Inventory (SCI)

30 items scored 0-100. A higher score indicates better self-care. This theoretically-derived instrument has construct validity. The self-care confidence scale is embedded within this instrument.

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Maintenance Baseline71.4 score on a scaleStandard Deviation 14.1
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Monitoring Baseline60.5 score on a scaleStandard Deviation 19.8
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Management Baseline54.6 score on a scaleStandard Deviation 21.2
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Monitoring Month 677.8 score on a scaleStandard Deviation 16.6
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Maintenance Month 680.4 score on a scaleStandard Deviation 12
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Confidence Baseline66.3 score on a scaleStandard Deviation 20.1
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Management Month 670.7 score on a scaleStandard Deviation 15.6
ViCCY: Health Information + Health CoachingChange From Baseline in the Self-Care Inventory (SCI)SCI Confidence Month 679.6 score on a scaleStandard Deviation 18.7
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Management Month 659.4 score on a scaleStandard Deviation 26.9
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Maintenance Baseline66.4 score on a scaleStandard Deviation 18.3
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Maintenance Month 668.9 score on a scaleStandard Deviation 14.7
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Management Baseline56.5 score on a scaleStandard Deviation 23.7
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Confidence Month 665.3 score on a scaleStandard Deviation 23.5
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Monitoring Baseline64.6 score on a scaleStandard Deviation 25.3
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Monitoring Month 664.0 score on a scaleStandard Deviation 24.4
Health InformationChange From Baseline in the Self-Care Inventory (SCI)SCI Confidence Baseline68.1 score on a scaleStandard Deviation 22.3
Secondary

Change From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)

CES-D is a valid and reliable scale for detecting caregiver depression in dementia. The scoring is on a likert scale 0: Rarely or none of the time (less than 1 day), 1: Some or a little of the time (1-2 days), 2: Occasionally or a moderate amount of time (3-4 days), and 3: Most or all of the time (5-7 days). Higher scores represent greater depressive symptoms. Total scores can range 0 to 60. A score equal or above a 16 means a person is at risk for clinical depression.

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)Baseline19.7 score on a scaleStandard Deviation 15.1
ViCCY: Health Information + Health CoachingChange From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)Month 615.3 score on a scaleStandard Deviation 11.3
Health InformationChange From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)Baseline19.0 score on a scaleStandard Deviation 12.8
Health InformationChange From Baseline in Center for Epidemiologic Studies Depression Scale (CES-D)Month 616.6 score on a scaleStandard Deviation 10.4
Secondary

Change From Baseline in Neuropsychiatric Inventory

Commonly used scale to evaluate 12 common behaviors in dementia including Delusions, Hallucinations, Agitation/Aggression, Depression, Anxiety, Elation/Euphoria, Apathy/Indifference, Disinhibition, Irritability, Aberrant motor behavior, Sleep and Nighttime Behavior Disorders, Appetite and Eating Disorders. Ratings include the frequency of the occurrence of behaviors (1 = occasionally, 2 = often, 3 = frequently, 4 = very frequently), and the level of severity of behaviors (1 = mild, 2 = moderate, 3 = severe). The behavioral domain total score is the product of the frequency score multiplied by the severity score for that behavior. The NPI total score is the sum of all the individual behavioral domains. Scores range from 0-144. Higher scores demonstrate greater symptoms frequency and severity.

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Neuropsychiatric InventoryMonth 614.6 score on a scaleStandard Deviation 8.2
ViCCY: Health Information + Health CoachingChange From Baseline in Neuropsychiatric InventoryBaseline20.4 score on a scaleStandard Deviation 15.7
Health InformationChange From Baseline in Neuropsychiatric InventoryMonth 623.8 score on a scaleStandard Deviation 15.4
Health InformationChange From Baseline in Neuropsychiatric InventoryBaseline23.4 score on a scaleStandard Deviation 17.3
Secondary

Change From Baseline in Perceived Stress Scale

The Perceived Stress Scale is a 14-item instrument that provides a global rating of an individual's belief in the severity and frequency of stressful experiences during the last month. The Perceived Stress Scale includes 14 items designed to assess symptoms of stress and global measures of the degree of stress experienced in the past month. Each item is scored from 0 (never) to 4 (very often), with total sum scores ranging from 0 to 56; higher scores indicate higher perceived stress.

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Perceived Stress ScaleBaseline23.1 score on a scaleStandard Deviation 10
ViCCY: Health Information + Health CoachingChange From Baseline in Perceived Stress ScaleMonth 623.4 score on a scaleStandard Deviation 12.4
Health InformationChange From Baseline in Perceived Stress ScaleBaseline29.2 score on a scaleStandard Deviation 8.7
Health InformationChange From Baseline in Perceived Stress ScaleMonth 628.4 score on a scaleStandard Deviation 8.3
Secondary

Change From Baseline in Ways of Coping Questionnaire, Short Form

This 42-item questionnaire measures the use of five different coping styles: avoidance, problem-focused, seeking social support, self-blame, and wishful thinking. The original scale has been used widely since developed by Lazarus in 1985. The short version (30 items) uses a 4-point Likert-scale response format (0 = not used to 3 = used a great deal). Scores range from 0-90 with higher scores indicating greater coping. It is reliable (alpha 0.95) and has construct validity. This instrument has been used numerous times in studies with older adult caregivers.

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Ways of Coping Questionnaire, Short FormBaseline22.7 score on a scaleStandard Deviation 16
ViCCY: Health Information + Health CoachingChange From Baseline in Ways of Coping Questionnaire, Short FormMonth 623.4 score on a scaleStandard Deviation 15.9
Health InformationChange From Baseline in Ways of Coping Questionnaire, Short FormBaseline20.4 score on a scaleStandard Deviation 15
Health InformationChange From Baseline in Ways of Coping Questionnaire, Short FormMonth 619.1 score on a scaleStandard Deviation 14.6
Secondary

Change From Baseline in Zarit Burden Interview (ZBI)

The ZBI has been used in numerous informal dementia caregiver studies to capture burden associated with providing care to a loved one. Total scores are summed and a range is provided for little to no burden (0-21) to severe burden (61-88).

Time frame: 6 months

ArmMeasureGroupValue (MEAN)Dispersion
ViCCY: Health Information + Health CoachingChange From Baseline in Zarit Burden Interview (ZBI)Baseline38.4 score on a scaleStandard Deviation 11.4
ViCCY: Health Information + Health CoachingChange From Baseline in Zarit Burden Interview (ZBI)Month 639.3 score on a scaleStandard Deviation 14.9
Health InformationChange From Baseline in Zarit Burden Interview (ZBI)Baseline43.6 score on a scaleStandard Deviation 13.6
Health InformationChange From Baseline in Zarit Burden Interview (ZBI)Month 646.3 score on a scaleStandard Deviation 12.8

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026