EFFECTS OF A TELEHEALTH PROGRAM ON THE LEVEL OF PHYSICAL ACTIVITY OF ELDERLY PEOPLE WITH DEMENTIA AND THEIR CAREGIVERS DURING THE COVID-19 PANDEMIC: A RANDOMIZED AND CONTROLLED CLINICAL TRIAL

• Grant number: 23/11423-1
• Support Opportunities: Scholarships in Brazil - Doctorate
• Effective date (Start): August 01, 2024
• Effective date (End): April 30, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Larissa Pires de Andrade
• Grantee: Andréa Rodrigues de Amorim Molina
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Introduction: Telehealth programs can be a viable intervention strategy, as they allow access to health activities at a distance. The level of Physical Activity (PAL) is an important ally to preserve the quality of life (QoL), reduce stress and burden on caregivers, in addition to being an important factor for protecting the loss of functionality of elderly people with dementia. However, few studies have investigated the effect of a multimodal telehealth program on elderly people with dementia and their caregivers and the influence of PAL on stress, burden and QoL in the complex context of the COVD-19 pandemic. Objectives: Study 1) To analyze the effect of a multidisciplinary telehealth program on the PAL of elderly people with dementia (mild and moderate stages) and its influence on behavioral symptoms and QoL of the elderly person with dementia and, burden, stress and QoL of the caregiver ; Study 2) To analyze the influence of PAL on the burden, stress and QoL of caregivers of elderly people with dementia during the COVID-19 pandemic. Methodology: This project comprises two ongoing studies: Study 1: Randomized and controlled clinical trial, with pre and post assessments of three months of intervention and three-month follow-up, comprising 80 elderly people with dementia with a clinical diagnosis of dementia according to DSM-V and their caregivers, randomly divided into two groups: Telehealth Group (TG) and Control Group (CG). In the TG, elderly people with dementia performed a Multidisciplinary Telehealth protocol consisting of systematic physical and cognitive exercises, and their caregivers received psychoeducation with guidance on dementia and coping with social distancing from COVID-19. The CG only received psychoeducation at the beginning of the proposed period and was questioned monthly about possible clinical intercurrences during the research period. Treatment effects will be calculated through the construction of mixed analysis of variance models (MANOVA - Repeated Measured, Within between interaction). Multiple linear regression will be applied to verify the influence of the level of physical activity, stress, overload and quality of life, a significance level of 5% (p<0.05) will be adopted. Study 2: Cross-sectional study, comprising 80 caregivers of elderly people with dementia. For data analysis, Pearson and Spearman tests will be used in addition to the Generalized Linear Model. The assessment instruments used in Studies 1 and 2 were: Elderly People with Dementia - Anamnesis; Clinical Dementia Rating Score (CDR); Social Distancing Questionnaire (QDS) and COVID-19 Loneliness and Social Connectedness Questionnaire (QCOVID-19); Modified Baecke Questionnaire for the Elderly (BAECKE); QoL Scale for Patients with Alzheimer's Disease (QdL-AD) elderly version; Neuropsychiatric Inventory (questionnaire) NPI - Q; Caregivers - Anamnesis; Social Distancing Questionnaire (QDS) and the COVID-19 Questionnaire (QCOVID19); International PA Questionnaire (IPAQ); Perceived Stress Scale (PSS) and Zarit Burden Scale (ZARIT); QdV-DA caregiver version. Expected Results: Regarding Study 1, it is expected that the telehealth program carried out in elderly people with dementia is effective in improving their PAL of their caregivers. And in relation to Study 2, it is expected that there is a direct correlation between the level of PA and QoL and overload in the participants.