Adjunctive Therapy to Manage Neuropsychiatric Symptoms in Moderate and Severe Dementia: Randomized Clinical Trial Using an Outpatient Version of Tailored Activity Program

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Oliveira, Alexandra Martini ^{[1, 2]} ; Radanovic, Marcia ^[2] ; Homem de Mello, Patricia Cotting ^[1] ; Buchain, Patricia Cardoso ^[1] ; Barbosa Vizzotto, Adriana Dias ^[1] ; Harder, Janaina ^[3] ; Stella, Florindo ^[2] ; Gitlin, Laura N. ^{[4, 5, 6]} ; Piersol, Catherine Verrier ^[7] ; Valiengo, Leandro L. C. ^[2] ; Forlenza, Orestes Vicente ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Hosp Clin, Fac Med, Serv Terapia Ocupac, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Hosp Clin, Fac Med, Lab Neurociencias LIM 27, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Hosp Clin, Fac Med, Inst Psiquiatria, Sao Paulo - Brazil

^[4] Johns Hopkins Univ, Sch Nursing, Baltimore, MD - USA

^[5] Johns Hopkins Ctr Innovat Care Aging, Baltimore, MD - USA

^[6] Drexel Coll Nursing & Hlth Profess, Philadelphia, PA - USA

^[7] Thomas Jefferson Univ, Dept Occupat Therapy, Philadelphia, PA 19107 - USA

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF ALZHEIMER'S DISEASE; v. 83, n. 1, p. 475-486, 2021.
• Citações Web of Science: 0

Resumo

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. (AU)

• Processo FAPESP: 14/14211-6 - Comprimento telomérico no sistema nervoso central de um modelo de Doença de Alzheimer tratado com lítio
• Beneficiário: Giancarlo de Mattos Cardillo
• Modalidade de apoio: Bolsas no Brasil - Mestrado
• Processo FAPESP: 16/01302-9 - Identificação das vias direta e indireta da inibição da glicogênio sintase kinase 3B pelo lítio em cultura de neurônios
• Beneficiário: Vanessa de Jesus Rodrigues de Paula
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 09/52825-8 - Neurobiologia da doença de Alzheimer: marcadores de risco, prognóstico e resposta terapêutica
• Beneficiário: Wagner Farid Gattaz
• Modalidade de apoio: Auxílio à Pesquisa - Temático