Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study

Pimouguet, Clément; Goff, Mélanie Le; Wittwer, Jérôme; Dartigues, Jean‐François; Helmer, Catherine

doi:10.3233/jad-160820

Cited by 20 publications

(17 citation statements)

References 37 publications

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“…However, the service did not strictly conform to protocols formerly tested in randomized trials but rather drew on specific strategies and components that were then consistently and systematically delivered. Pre-post evaluation of the service showed maintenance of function over 3 months, stabilization of behaviors, and reductions in caregiver burden over 6 months, similar to previous trial findings ( Pimouguet, Le Goff, Wittwer, Dartigues, & Helmer, 2017 ).…”

supporting

confidence: 86%

Supporting Family Caregivers of Persons With Dementia in the Community: Description of the ‘Memory Care Home Solutions’ Program and Its Impacts

Gitlin

Cigliana²,

Cigliana

et al. 2017

Innovation in Aging

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Background and Objectives Most persons with dementia live at home, cared for by families with limited access to supportive services. We describe “Memory Care Home Solutions” (MCHS), a community-based dementia care program, and evaluate enrollees’ characteristics, strategies provided and implemented, and impact on adverse health-related events (emergency medical calls, emergency room visits, hospitalizations, falls) of persons with dementia. Research Design and Methods Retrospective observational study of MCHS’ Basic (5 contacts) and Enhanced (additional 4 occupational therapy contacts) services for enrolled caregivers (September 1, 2014 to March 31, 2016). In both programs, caregivers received dementia education, care strategies, and social support. For Enhanced, caregivers had additional opportunities to practice care strategies. Caregivers were interviewed by interventionists at intake, 3 and 6 months (in-person or telephone). Results Of 717 enrolled caregivers, most were female (73.1%), nonspouses (58.2%), Caucasian (70.8%), 63.02 (standard deviation [SD] = 13.20) years old, and caring for persons with dementia of low income (54.1%, <$39,000). Caregivers reported managing on average 11.64 (SD = 4.64) behavioral symptoms and high functional dependence (6 instrumental activities of daily living [IADLs]; 2 activities of daily living [ADLs]). Caregivers opting for Enhanced (N = 314, 44.9%) were older (p = .025), spouses (p = .002), reported greater distress with behaviors (p = .051), and managed higher dependence (ADLs, p = .018; IADLs, p = .002) than caregivers in Basic (N = 403, 56.2%). Of 1,462 strategies offered, 68.9% were implemented with no differences in implementation rate between the 2 programs. Of 279 families with follow-up, 53.4% (N = 149) reported ≥1 adverse health-related events over 3-months pre-enrollment. By 3-months post-enrollment, 27.2% (N = 76) reported ≥1 adverse events; reflecting a 51.0% reduction in caregivers reporting events (p < .0005). African Americans, Whites, spouses, and nonspouses benefited similarly. Discussion and Implications MCHS offers brief supportive services, resulting in fewer adverse health-related events of persons with dementia. Families managing high functional dependence opted for more assistance from occupational therapists. Evaluating real-world programs yields new understandings of caregiver service preferences for staff planning.

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supporting

confidence: 86%

Supporting Family Caregivers of Persons With Dementia in the Community: Description of the ‘Memory Care Home Solutions’ Program and Its Impacts

Gitlin

Cigliana²,

Cigliana

et al. 2017

Innovation in Aging

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“…Patients are referred to ESA under medical prescription. We selected 10 ESA that were already involved in the pilot study (described elsewhere) and showed a high recruitment capacity [15]. Moreover, patients cared by these settings have been shown to be representative of the patients care by ESA at the national level [16].…”

Section: Methodsmentioning

confidence: 99%

“…The participants allocated to the control group benefit from the usual intervention described previously [15]. Briefly, patients referred to ESA followed a standardized treatment procedure consisting of 12 to 15 home sessions performed by a therapist over a period of 3/4 months focusing on patients and potential primary caregivers.…”

Section: Methodsmentioning

confidence: 99%

“…Yet, real-world studies are scarce. Recently, within an observational study based on routine care practice we showed that patients benefiting from OT experienced a stabilization in their functional performances over the 3/4 months intervention period before a worsening phase [15]. They also reported a decrease of their behavioral troubles followed by a stabilization phase.…”

Section: Introductionmentioning

confidence: 99%

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Maintenance of occupational therapy (OT) for dementia: protocol of a multi-center, randomized controlled and pragmatic trial

Pimouguet

Sitta²,

Wittwer

et al. 2019

BMC Geriatr

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BackgroundThere is a growing interest in developing tailored non-pharmacological strategies to face patients’ needs in dementia. Occupational therapy (OT) may contribute to promote self-empowerment of both patients and caregivers. France has implemented nationwide OT over a short-term period of 3/4 months. The main objective of the MathéoAlz study is to measure the impact of maintaining OT over 4 supplementary months on patients’ neuropsychiatric symptoms.Methods/designThe MatheoAlz trial (Maintenance of Occupational Therapy in Alzheimer’s disease) is a multi-center, pragmatic randomized controlled trial testing maintenance of OT over 4 supplementary months compared to routine OT delivered as recommended. This paper describes the study protocol. MatheoAlz plans to enroll 240 dyads, i.e. dementia patients and caregivers, whose main inclusion criteria are: prescription for routine OT, patients with mild or moderate dementia, living at home, receiving support from an informal caregiver. The study will compare a control group of patients benefiting from 12 to 15 initial sessions of OT over 3/4 months and an intervention group of patients benefiting from these initial sessions plus 8 extra home sessions over 4 supplementary months. The main outcome is the patient’s neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory at 8 months. Several clinical outcomes and economic consequences are measured at 4, 8 and 12 months.DiscussionThis is the first trial designed to assess the specific impact of the maintaining OT on the patients’ neuropsychiatric symptoms burden. The results will inform policymakers on strategies to implement in the near future.Trial registrationThis trial was registered at ClinicalTrials.gov on February 16, 2018, identifier: NCT03435705.

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“…The short-term efficacy of OT has been very recently investigated and ascertained in patients with dementia by Pimouguet et al (Pimouguet, Le Goff, Wittwer, Dartigues, & Helmer, 2017 (Pimouguet et al, 2017).…”

Section: Non-pharmacological Interventionsmentioning

confidence: 99%

A methodological framework for exploring the applicability of virtual reality in cognitive disabilities care

Betances¹,

Isabel²

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There is always going to be a reason why you can't do something, your job is toconstantly look for the reasons why you can achieve your dreams. Shannon Miller -7x Olympic Gymnast medallist AcknowledgmentsI would like to firstly express my sincere gratitude to my advisor ProfessorMaría Teresa Arredondo Waldmeyer for her continuous support of my PhD studies and related research, and for her inspiration, tenacity, and immense knowledge.In addition to my advisor, I thank Prof. María Fernanda Cabrera-Umpiérrez and Prof. Francisco J. García-Sánchez, not only for their insightful commentaries and supportive encouragement, but also for the helpful suggestions and revision recommendations which motivated me to extend the scope of my research work to wider perspectives.I also thank my former colleagues and present fellow teammates at LifeSTech for the stimulating discussions, help and advice, as well as for the interesting times we shared working and learning together at several projects during the last years.Last but not least, I thank my family and friends for supporting all my life goals and purposes, and for the patience shown while I was writing this thesis.ix AbstractHandling the care needs of people affected by Alzheimer's disease and related dementias (ADRD) represents nowadays a personal, familial and social challenge of enormous proportions, which poses an ever growing human and economic burden on the world's society in general. Information and communication technologies (ICT) have the potential to make a considerable impact to help revert this trend, especially through the use of advanced virtual reality (VR)-based computerized diagnostic and therapeutic cognitive interventions for people living with, or at risk of developing,ADRD. This doctoral thesis aims to facilitate the use of such VR-based interventions.To that end, it makes specific original contributions regarding: the categorization of VR systems particularly designed for ADRD; an analysis and assessment of the current relevance and impact of the 'brain training debate' involving commercial brain training products; an up-to-date critical description of the technical and scientific challenges faced today for the development of effective VR-based cognitive training tools; and finally, this thesis proposes a novel methodological design framework to provide guidance to researchers and developers with the design process of VR-based tools to address the care needs of people with ADRD. The framework is based on our previous critical analysis of the most recent knowledge available about VR cognitive interventions. The framework and its ensuing roadmap take into account, not only universal design principles, standard techniques and methodologies, but also addresses the specific aspects of accessibility and usability that are particular to the use VR-based platforms on patients with ADRD-associated cognitive impairments.x xi ResumenEl manejo de las necesidades de atención de las personas afectadas por la enfermedad de Alzheimer y demencias relacionadas (EADR)...

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Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study

Abstract: OT may be an effective intervention to maintain cognition and functionality and to reduce psychiatric symptoms in dementia patients. Mild stages of dementia could gain more benefits from OT with regard to functional decline.

Cited by 20 publications

References 37 publications

Supporting Family Caregivers of Persons With Dementia in the Community: Description of the ‘Memory Care Home Solutions’ Program and Its Impacts

Supporting Family Caregivers of Persons With Dementia in the Community: Description of the ‘Memory Care Home Solutions’ Program and Its Impacts

Maintenance of occupational therapy (OT) for dementia: protocol of a multi-center, randomized controlled and pragmatic trial

A methodological framework for exploring the applicability of virtual reality in cognitive disabilities care

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