TY - JOUR
T1 - Adjunctive Therapy to Manage Neuropsychiatric Symptoms in Moderate and Severe Dementia
T2 - Randomized Clinical Trial Using an Outpatient Version of Tailored Activity Program
AU - Oliveira, Alexandra Martini
AU - Radanovic, Marcia
AU - Mello, Patricia Cotting Homem De
AU - Buchain, Patricia Cardoso
AU - Vizzotto, Adriana Dias Barbosa
AU - Harder, Janaína
AU - Stella, Florindo
AU - Gitlin, Laura N.
AU - Piersol, Catherine Verrier
AU - Valiengo, Leandro L.C.
AU - Forlenza, Orestes Vicente
N1 - Funding Information:
This clinical trial is the first controlled study to address the effectiveness of an occupational therapy intervention based on the outpatient version of the TAP method to reduce some NPS in patients with moderate to severe dementia. This study contributes to the growing body of evidence reinforcing the effectiveness and benefits of occupational therapy in the The Laboratory of Neuroscience (LIM-27), University of Sao Paulo, receives financial support from the Alzira Denise Hertzog Silva Association (ABA DHS), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Sao Paulo Research Foundation (FAPESP; Projects 09/52825-8, 2014/ 14211-6, 2016/01302-9) and National Council for Scientific and Technological Development (CNPq; Projects 442795/2014-9 and 466625/2014-6).
Funding Information:
The Laboratory of Neuroscience (LIM-27), University of Sao Paulo, receives financial support from the Alzira Denise Hertzog Silva Association (ABADHS), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Sao Paulo Research Foundation (FAPESP; Projects 09/52825-8, 2014/14211-6, 2016/01302-9) and National Council for Scientific and Technological Development (CNPq; Projects 442795/2014-9 and 466625/2014-6).
Publisher Copyright:
© 2021 - IOS Press. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Neuropsychiatric symptoms (NPS) such as aggression, apathy, agitation, and wandering may occur in up to 90%of dementia cases. International guidelines have suggested that non-pharmacological interventions are as effective as pharmacological treatments, however without the side effects and risks of medications. An occupational therapy method, called Tailored Activity Program (TAP), was developed with the objective to treat NPS in the elderly with dementia and has been shown to be effective. Objective: Evaluate the efficacy of the TAP method (outpatient version) in the treatment of NPS in individuals with dementia and in the burden reduction of their caregivers. Methods: This is a randomized, double-blind, controlled clinical trial for the treatment of NPS in dementia. Outcome measures consisted of assessing the NPS of individuals with dementia, through the Neuropsychiatric Inventory-Clinician rating scale (NPI-C), and assessing the burden on their caregivers, using the Zarit Scale. All the participants were evaluated pre-and post-intervention. Results: 54 individuals with dementia and caregivers were allocated to the experimental (n=28) and control (n=26) groups. There was improvement of the following NPS in the experimental group: delusions, agitation, aggressiveness, depression, anxiety, euphoria, apathy, disinhibition, irritability, motor disturbance, and aberrant vocalization. No improvement was observed in hallucinations, sleep disturbances, and appetite disorders. The TAP method for outpatient settings was also clinically effective in reducing burden between caregivers of the experimental group. Conclusion: The use of personalized prescribed activities, coupled with the caregiver training, may be a clinically effective approach to reduce NPS and caregiver burden of individuals with dementia.
AB - Background: Neuropsychiatric symptoms (NPS) such as aggression, apathy, agitation, and wandering may occur in up to 90%of dementia cases. International guidelines have suggested that non-pharmacological interventions are as effective as pharmacological treatments, however without the side effects and risks of medications. An occupational therapy method, called Tailored Activity Program (TAP), was developed with the objective to treat NPS in the elderly with dementia and has been shown to be effective. Objective: Evaluate the efficacy of the TAP method (outpatient version) in the treatment of NPS in individuals with dementia and in the burden reduction of their caregivers. Methods: This is a randomized, double-blind, controlled clinical trial for the treatment of NPS in dementia. Outcome measures consisted of assessing the NPS of individuals with dementia, through the Neuropsychiatric Inventory-Clinician rating scale (NPI-C), and assessing the burden on their caregivers, using the Zarit Scale. All the participants were evaluated pre-and post-intervention. Results: 54 individuals with dementia and caregivers were allocated to the experimental (n=28) and control (n=26) groups. There was improvement of the following NPS in the experimental group: delusions, agitation, aggressiveness, depression, anxiety, euphoria, apathy, disinhibition, irritability, motor disturbance, and aberrant vocalization. No improvement was observed in hallucinations, sleep disturbances, and appetite disorders. The TAP method for outpatient settings was also clinically effective in reducing burden between caregivers of the experimental group. Conclusion: The use of personalized prescribed activities, coupled with the caregiver training, may be a clinically effective approach to reduce NPS and caregiver burden of individuals with dementia.
KW - Caregiver burden
KW - dementia
KW - family caregiving
KW - neuropsychiatric behaviors
KW - non-pharmacologic intervention
KW - occupational therapy
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U2 - 10.3233/JAD-210142
DO - 10.3233/JAD-210142
M3 - Article
C2 - 34334394
AN - SCOPUS:85114398258
SN - 1387-2877
VL - 83
SP - 475
EP - 486
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 1
ER -