Aggression Prevention Training for Individuals With Dementia and Their Caregivers: A Randomized Controlled Trial

Area of Science:

• Gerontology
• Psychiatry
• Behavioral Science

Background:

• Behavioral problems in individuals with dementia (IWD) impose significant costs on patients, families, and society.
• Existing interventions for aggression in IWD have shown modest efficacy, necessitating the exploration of novel preventive strategies.

Purpose of the Study:

• To evaluate the efficacy of Aggression Prevention Training (APT) in reducing aggression incidence in individuals with dementia (IWD).
• To assess the impact of APT on pain, depression, caregiver-IWD relationship quality, and other secondary outcomes over one year.

Main Methods:

• A randomized controlled trial was conducted with 228 caregiver-IWD dyads screened for pain, depression, or relationship problems.
• Participants were randomized to receive either APT, a 3-month skills-based intervention, or Enhanced Usual Primary Care (EU-PC).
• Aggression was measured using the Cohen Mansfield Agitation Inventory-Aggression Subscale; secondary outcomes included depression and relationship quality.

Main Results:

• No significant differences in aggression incidence or most secondary outcomes were observed between the APT and EU-PC groups over one year.
• In participants with depression or relationship problems, the EU-PC group showed increased depression and decreased relationship quality.
• Conversely, participants receiving APT demonstrated no significant changes in depression or caregiver-IWD relationship quality over time.

Conclusions:

• While APT did not reduce aggression, it appeared to stabilize depression and caregiver-IWD relationship quality in specific subgroups.
• Novel preventive approaches are needed given the high cost of behavioral problems in IWD and the limitations of current interventions.