المؤلفون: Eikelboom, Willem S., Van Den Berg, Esther, Coesmans, Michiel, Goudzwaard, Jeannette A., Koopmanschap, Marc, Lazaar, Najoua, Van Bruchem-Visser, Rozemarijn L., Driesen, Jan J.M., Den Heijer, Tom, Hoogers, Susanne, De Jong, Frank Jan, Mattace-Raso, Francesco U. S., Thomeer, Elsbeth C., Vrenken, Suzanne, Vroegindeweij, Lilian J.H.M., Zuidema, Sytse U., Singleton, Ellen H., Van Swieten, John C., Ossenkoppele, Rik, Papma, Janne M.

المصدر: Journal of Alzheimer's Disease MultiPark: Multidisciplinary research focused on Parkinson´s disease. 93(4):1407-1423

مصطلحات موضوعية: Alzheimer's disease, apathy, behavioral and psychological symptoms of dementia, delivery of care, dementia, depression, neuropsychiatric inventory, neuropsychiatric symptoms, Medicin och hälsovetenskap, Klinisk medicin, Geriatrik, Medical and Health Sciences, Clinical Medicine, Geriatrics, Annan medicin och hälsovetenskap, Gerontologi, medicinsk/hälsovetenskaplig inriktning, Other Medical Sciences, Gerontology, specializing in Medical and Health Sciences

الوصف: Background: Neuropsychiatric symptoms (NPS) are highly prevalent in Alzheimer's disease (AD) and are associated with negative outcomes. However, NPS are currently underrecognized at the memory clinic and non-pharmacological interventions are scarcely implemented. Objective: To evaluate the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) method™ to improve the care for NPS in AD at the memory clinic. Methods: We enrolled sixty community-dwelling people with mild cognitive impairment or AD dementia and NPS across six Dutch memory clinics with their caregivers. The first wave underwent care as usual (n = 36) and the second wave underwent the DICE method (n = 24). Outcomes were quality of life (QoL), caregiver burden, NPS severity, NPS-related distress, competence managing NPS, and psychotropic drug use. Reliable change index was calculated to identify responders to the intervention. A cost-effectiveness analysis was performed and semi-structured interviews with a subsample of the intervention group (n = 12). Results: The DICE method did not improve any outcomes over time compared to care as usual. Half of the participants of the intervention group (52%) were identified as responders and showed more NPS and NPS-related distress at baseline compared to non-responders. Interviews revealed substantial heterogeneity among participants regarding NPS-related distress, caregiver burden, and availability of social support. The intervention did not lead to significant gains in quality-adjusted life years and well-being years nor clear savings in health care and societal costs. Conclusion: The DICE method showed no benefits at group-level, but individuals with high levels of NPS and NPS-related distress may benefit from this intervention.

URL الوصول: https://lup.lub.lu.se/record/704415e5-bbd2-4fcf-9768-93cc5679a8be
http://dx.doi.org/10.3233/JAD-230116