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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

Model

Human

Conent Area

Patrick Pui Kin Kor

EWB-Related Construct

(4) quality of life

Study Design

Species or Study Population

(5) RCT

Sex (%Female)

People with dementia: 59.2%
Caregivers: 79.7%

Age (Mean, SD)

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

Younger Controls?

No

Longitudinal Data?

Yes

Sample Size

230

Interventions

Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention

Ethnicity (%white)

not stated (Hongkong)

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.

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.

EWB Measures

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

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

Physiological Measures

N/A

Brain IMaging Modality

Brain IMaging Paradigm

N/A

Brain Region/Circuit

N/A

Biological Measures

N/A

Other Neural Measures

Data Availability?

Yes

Data Avalability 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.

Diagnostic Measures

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