Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial

Contact Information

Keywords

Patrick Pui Kin Kor patrick.kor@polyu.edu.hk

Caregiver-led interventions, Cognitive impairment, Neuropsychiatric symptoms

Abstract

Background and objectives: Many community dementia services such as home-visiting services and center-based activities were suspended during the coronavirus 2019 pandemic. This study investigated the efficacy of a caregiver-delivered cognitive stimulation therapy (CDCST) on people with dementia during the pandemic. Research design and methods: This was a 2-arm randomized controlled trial involving 241 patient-caregiver dyads assigned to a 15-week CDCST or control group (usual care). We hypothesized that CDCST would facilitate significant improvements among people with dementia (cognition, behavioral/psychiatric symptoms, and quality of life) and their caregivers (caregiving appraisal, attitudes, and psychological well-being) at postintervention (T1) and at the 12-week follow-up (T2). Generalized estimating equations evaluated the study outcomes. Results: A total of 230 dyads completed the study, with good program adherence (93%). Participants in the CDCST showed significant improvements in cognition (p < .001), behavioral and psychiatric symptoms (p =. 027), and quality of life (p =.001) at the 3-month follow-up period. Family caregivers had improved positive aspects of caregiving (p = .008; p = .049) and decreased negative attitudes toward people with dementia (p =. 013; p < .001) at both T1 and T2. There were nonsignificant changes in the caregivers' perceived burden, distress, and psychological well-being. Discussion and implications: Family caregivers could be trained to provide cognitive stimulation at home for people with dementia, which could benefit both parties. CDCST could manage to improve the cognition, neuropsychiatric symptoms, and quality of life of people with dementia, while also improving caregiving appraisal and negative attitudes among family caregivers.

Citation

Kor, P. P. K., Parial, L. L., Yu, C. T. K., Liu, J. Y. W., Liu, D. P. M., & Hon, J. M. K. (2024). Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial. The Gerontologist, 64(2), gnad054. https://doi.org/10.1093/geront/gnad054

DOI

10.1093/geront/gnad054

EWB Constructs:

(4) quality of life

EWB Measures:

Quality of Life in Alzheimer’s Disease Scale (QoL-AD)

data availability:

Yes

data availability details:

The study protocol has been pre-registered in ClinicalTrials.gov (NCT03803592). The conditions of our ethics approval do not allow us to publicly archive or share the study data with nonmembers of the research team. To seek access to the data, analytic methods, and materials related to this study, interested readers should contact the corresponding author (P. Kor) to discuss data sharing agreement.

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

We excluded people with dementia and caregivers who had been diagnosed with a physical or mental condition in an acute phase (e.g., bipolar disorder, schizophrenia, cancer, or acute stroke) that might affect their ability to participate in the program.

Inclusion Criteria

(1) People with dementia: (a) aged ≥65 years; (b) diagnosed with any type of dementia as defined by The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10); and (c) in the early to moderate stage of dementia, namely, Stages 4–6 according to the Global Deterioration scale.
(2) Family caregivers: (a) aged ≥18 years; (b) related by blood or marriage (e.g., a spouse, sibling, child, or grandchild) to the person with dementia, and has been assuming caring responsibilities ranging from providing physical aid, emotional support, assisting with transportation, finances, personal hygiene, and decision making; and (c) has been providing most of the daily care/support (daily contact for at least 4 hr.

Non-EWB Behavioral
Measures:

Montreal Cognitive Assessment
Neuropsychiatric Inventory-Questionnaire
Depression Anxiety Stress scale 21
Positive Aspect of Caregiving scale (PAC)
Family Attitude scale (FAS)
Zarit Burden Interview

First author:

Patrick Pui Kin Kor

species:

Human

sample size:

230

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention

study population:

(1) cognitively healthy adults
(2) patients with (pre)clinical dementia

sex (% female):

People with dementia: 59.2%
Caregivers: 79.7%

ethnicity (%white)

not stated (Hongkong)

Age (mean, sd):

People with dementia: 83.0, 8.0
Caregivers: 63.0, 11.3

biological/Physiological Measures:

N/A