Comprehensive, Individualized, Person-Centered Management of Community-Residing Persons with Moderate-to-Severe Alzheimer Disease: A Randomized Controlled Trial

Reisberg, Barry; Shao, Yongzhao; Golomb, James; Monteiro, Isabel; Torossian, Carol; Boksay, István; Shulman, Melanie; Heller, Sloane; Zhu, Zhi Wei; Atif, Ayesha; Sidhu, Jaskirat; Vedvyas, Alok; Kenowsky, Sunnie

doi:10.1159/000455397

Cited by 11 publications

(23 citation statements)

References 46 publications

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“…We identified three studies evaluating specialist palliative care services 19–21 and five evaluating non-specialist palliative care interventions (Table 2). 22–27 One study on non-specialist palliative care intervention was reported in two articles. 22,23 Four of the studies presented evidence from the United States, 19,20,24,25 two from Italy, 22,23,27 and one each from the United Kingdom 26 and Japan.…”

Section: Resultsmentioning

confidence: 99%

Palliative care for people with dementia living at home: A systematic review of interventions

et al. 2019

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Background: The European Association for Palliative Care White Paper defined optimal palliative care in dementia based on evidence and expert consensus. Yet, we know little on how to achieve this for people with dementia living and dying at home. Aims: To examine evidence on home palliative care interventions in dementia, in terms of their effectiveness on end-of-life care outcomes, factors influencing implementation, the extent to which they address the European Association for Palliative Care palliative care domains and evidence gaps. Design: A systematic review of home palliative care interventions in dementia. Data sources: The review adhered to the PRISMA guidelines and the protocol was registered with PROSPERO (CRD42018093607). We searched four electronic databases up to April 2018 (PubMed, Scopus, Cochrane library and CINAHL) and conducted lateral searches. Results: We retrieved eight relevant studies, none of which was of high quality. The evidence, albeit of generally weak quality, showed the potential benefits of the interventions in improving end-of-life care outcomes, for example, behavioural disturbances. The interventions most commonly focused on optimal symptom management, continuity of care and psychosocial support. Other European Association for Palliative Care domains identified as important in palliative care for people with dementia, for example, prognostication of dying or avoidance of burdensome interventions were under-reported. No direct evidence on facilitators and barriers to implementation was found. Conclusions: The review highlights the paucity of high-quality dementia-specific research in this area and recommends key areas for future work, for example, the need for process evaluation to identify facilitators and barriers to implementing interventions.

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Section: Resultsmentioning

confidence: 99%

Palliative care for people with dementia living at home: A systematic review of interventions

et al. 2019

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“…Other research likewise emphasizes benefits accruing from arts-based programming for persons in the middle to late stages of dementia (Young, Camic, & Tischler, 2015;Humphrey et al, 2019). Both the Olazarán et al (2010) and Reisberg et al (2017) studies confirm the efficacy of including person-centered programming in the treatment of persons across the multiple stages of ADRD. Over the past 20 years, there has been a steady shift from seeing dementia and those who "suffer" from it solely as a disease entity to be treated medically, to a chronic, progressive condition that benefits from interventions that build on an individual's capacity to learn and foster good quality of life.…”

Section: Evolving Perspectives On Adrd: From Disease-focused To Persomentioning

confidence: 81%

“…A more recent randomized controlled trial (Reisberg et al, 2017) examined the added benefits of a comprehensive, individualized, person centered management program (CI-PCM) in combination with a commonly prescribed to drug treatment of memantine for individuals with moderate-to-severe Alzheimer's Disease. The comprehensive, individualized, person centered management program was based on thirteen principles, which included, for example, (#6) treating persons with Alzheimer's Disease with dignity and respect as a person, not as an object, (#7) learning the Alzheimer's Disease person's history, individual tastes and preferences, talents, shortcomings, and personal needs, (#9) establishing a healthy, supportive, structured and flexible routine with daily fun scheduled in the routine, and (#10) using Memory Coaching to teach the Alzheimer's Disease person new skills, or skills they may have forgotten, helping to rebuild the Alzheimer's Disease person's self-esteem and self-respect (Reisberg et al, 2017, pp.…”

Section: Evolving Perspectives On Adrd: From Disease-focused To Persomentioning

confidence: 99%

Dementia Friendly Memory Institutions

Howarth

2019

IJIDI

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On November 3, 1906, at the 37th Meeting of South-West German Psychiatrists, Dr. Alois Alzheimer, reported on “a peculiar severe disease process of the cerebral cortex”. The disease with which he is associated has continued to elude a cure and is forecast to afflict one in eighty-five persons globally by 2050. Health care providers, researchers, and governments are on notice to explore different ways of understanding and addressing Alzheimer’s Disease and Related Dementias (ADRD) as demands for resources and funding escalate. One of those approaches, person-centered care (PCC), puts a focus on the individual, not the disease, emphasizing ability and enablement, and recognizing people with dementia as having rights of choice, personal empowerment, and self-determination. We expand on the concept of “dementia friendly communities,” embodying PCC, to envision how spaces, programs, and services within cultural heritage institutions such as galleries, libraries, archives, and museums (GLAM), could be re-thought and designed to enhance the everyday life experience of persons with ADRD. Impetus for such initiatives is provided further through the articulation, acceptance, adoption, and promotion of the rights of those with dementia as the rights of persons with disabilities. This emphasis on rights is important as it has behind it the force of international agreement and legally-binding United Nations’ Convention on the Rights of Persons with Disabilities (2008). We argue that cultural heritage institutions have a responsibility and a rationale for servicing those who have been marginalized across time by what they have rather than who they are.

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“…These drugs have modest symptomatic effects but do not have profound disease‐modifying effects [1]. Attempts to treat amyloid toxicity are underway by a number of groups [2,3], as are a variety of other approaches [4]. A complete review of current AD therapies can be found in a 2018 publication in this journal [5].…”

Section: Introductionmentioning

confidence: 99%

A randomized, double‐blind, placebo‐controlled trial of resveratrol with glucose and malate (RGM) to slow the progression of Alzheimer's disease: A pilot study

Zhu

Grossman

Neugroschl

et al. 2018

A&D Transl Res & Clin Interv

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IntroductionHuman studies on low-dose resveratrol are scarce. This study aims to evaluate the safety, tolerability, and efficacy of an oral preparation of resveratrol, glucose, and malate (RGM) in slowing the progression of Alzheimer's disease (AD).MethodsThirty-nine subjects with mild to moderate AD who were free of life-threatening disease and who did not have contraindications to the use of the study product were screened. Progression of AD was measured by change in the cognitive portion of the Alzheimer's Disease Assessment Scale–cognitive subscale. Secondary outcomes included Clinician's Global Impression of Change, Mini–Mental State Examination, Alzheimer's Disease Cooperative Study–Activities of Daily Living Scale, and Neuropsychiatric Inventory. 15 mL of the following preparation per dose, i.e., 5 g dextrose, 5 g malate, and 5 mg resveratrol, or matching placebo was ingested with an 8 oz glass of commercial unsweetened grape juice twice a day for 1 year. Group differences in the rate of change in the outcome measures were examined using generalized estimating equations.ResultsThe treatment and control groups were similar on all of the screening variables. At 12 months, change scores on Alzheimer's Disease Assessment Scale–cognitive subscale, Mini–Mental State Examination, Alzheimer's Disease Cooperative Study–Activities of Daily Living Scale, or Neuropsychiatric Inventory all showed less deterioration in the treatment than the control group; however, none of the change scores reached statistical significance. The most common AE were falls, all in the control group. None of the falls were deemed to be study related.ConclusionLow-dose oral resveratrol is safe and well tolerated. Interpretation of the effects on clinical outcomes trajectories remains uncertain. A larger study is required to determine whether low-dose resveratrol may be beneficial.Trial RegistrationClinicalTrials.gov (NCT00678431), Registered 05/15/2008.

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Comprehensive, Individualized, Person-Centered Management of Community-Residing Persons with Moderate-to-Severe Alzheimer Disease: A Randomized Controlled Trial

Cited by 11 publications

References 46 publications

Palliative care for people with dementia living at home: A systematic review of interventions

Palliative care for people with dementia living at home: A systematic review of interventions

Dementia Friendly Memory Institutions

A randomized, double‐blind, placebo‐controlled trial of resveratrol with glucose and malate (RGM) to slow the progression of Alzheimer's disease: A pilot study

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