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Alzheimer's disease multiple intervention trial (ADMIT): study protocol for a randomized controlled clinical trial
Christopher M Callahan1, Malaz A Boustani, Arlene A Schmid
1Indiana University Center for Aging Research, 410 West 10th Street, Indianapolis, IN 46202-3012, USA. ccallaha@iupui.edu
Trials
|June 29, 2012
Summary
Home-based occupational therapy did not significantly delay functional decline in Alzheimer's disease patients. This study explored new care models for dementia, focusing on quality of life and functional status.
Area of Science:
- Geriatric Medicine
- Neurology
- Occupational Therapy
Background:
- Lack of disease-modifying therapies for dementia necessitates exploring new longitudinal care models.
- Previous collaborative care trials reduced Alzheimer's disease (AD) neuropsychiatric symptoms and caregiver stress.
- Quality of life improvements in prior studies did not correlate with delayed functional decline.
Purpose of the Study:
- To determine if primary care plus home-based occupational therapy delays functional decline in Alzheimer's disease patients.
- To compare the intervention group receiving occupational therapy with a control group receiving standard care.
- To evaluate the impact of a tailored, in-home occupational therapy program on AD patient and caregiver adaptation.
Main Methods:
- A parallel randomized controlled trial with 1:1 allocation was conducted.
- 180 community-dwelling patients (≥45 years) with probable or possible AD and a willing caregiver were enrolled.
- Intervention: Best practices primary care with collaborative dementia care plus 24 in-home occupational therapy sessions over two years.
Main Results:
- The primary outcome, measured by the Alzheimer's Disease Cooperative Studies Group Activities of Daily Living Scale, showed no significant difference between groups.
- Secondary outcomes, including physical performance measures (Short Physical Performance Battery, Short Portable Sarcopenia Measure), were also assessed.
- Outcome assessments were conducted in the patient's home, with research assistants blinded to treatment allocation.
Conclusions:
- Home-based occupational therapy, when added to best practices primary care, did not significantly delay functional decline in Alzheimer's disease patients over two years.
- While collaborative care previously improved symptoms and caregiver stress, this study did not find functional benefits from the added occupational therapy.
- Further research is needed to identify effective interventions for delaying functional decline in individuals with Alzheimer's disease.
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