Alzheimer's Disease Multiple Intervention Trial - ADMIT

阿尔茨海默病多重干预试验 - ADMIT

基本信息

批准号：
8111085
负责人：
CHRISTOPHER M CALLAHAN
金额：
$ 54.25万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-15 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8111085
关键词：
Activities of Daily Living Acute Alzheimer&apos s Disease American Behavioral Behavioral Symptoms Boxing Caregiver Burden Caregivers Caring Clinical Services Clinical Trials Cognitive Communities Community Services Complex Computers Conduct Clinical Trials Control Groups Dementia Diagnosis Distal Education Educational Materials Effectiveness Elderly Emotional Enrollment Equipment and supply inventories Family Caregiver Goals Guidelines Health Care Costs Healthcare Home Nursing Care Home environment Hospitalization Impaired cognition Institutionalization Intervention Intervention Trial Learning Literature Medical Mental Health Methods Modeling Occupational Therapy Outcome Patients Pharmacotherapy Physical Function Physicians Population Preventive Primary Health Care Provider Published Comment Quality of Care Quality of life Randomized Controlled Clinical Trials Rehabilitation therapy Relative (related person)Reporting Research Research Personnel Resources Self Management Site Symptoms Syndrome Testing Time Work base caregiver education chronic care model collaborative care design disability experience functional decline group intervention improved improved functioning neuropsychiatry patient oriented patient population psychologic public health relevance research study treatment as usual

项目摘要

DESCRIPTION (provided by applicant): The proposed study builds on our findings from a previous clinical trial that demonstrated the effectiveness of collaborative care for older adults with Alzheimer's disease cared for in primary care practices. In the prior trial, we demonstrated that guideline-level medical care resulted in improved quality of care and improved behavioral and psychological symptoms over one year among patients and their caregivers. However, despite finding significant differences among study groups on Neuropsychiatric Inventory scores, we did not find a significant difference between groups in functional decline. Both study groups experienced a significant decline in function over 18 months. The current study proposes to test a home-based intervention specifically designed to slow the rate of functional decline among older adults with Alzheimer's disease. In addition to building on our past research, the study also builds from recently reported research which demonstrated the short-term efficacy of home-based occupational therapy interventions among older adults with dementia. These trials show that older adults with dementia, including Alzheimer's disease, can both participate in and benefit from occupational therapy-based interventions delivered in the home. The specific aim of this study is to conduct a two-year, randomized, controlled clinical trial to improve functioning among older adults with Alzheimer's disease by comparing a control group receiving best practices primary care with an intervention group receiving best practice primary care plus a home-based occupational therapy intervention. We will test the primary hypothesis that subjects with Alzheimer's disease in the intervention group will have improved function at two years compared with the best practice primary care control group. PUBLIC HEALTH RELEVANCE: More than 4 million Americans suffer from Alzheimer's disease and even under optimistic scenarios of the effectiveness of new treatments, this number will triple over the next few decades. For this reason, effective approaches to providing longitudinal care in the community for this burgeoning population are urgently needed.

描述（由申请人提供）：拟议的研究以我们先前的临床试验的发现为基础，该研究证明了对老年人患有在初级保健实践中受到关注的老年人的协作护理的有效性。在先前的试验中，我们证明了指南级的医疗护理可在患者及其护理人员的一年中提高护理质量，并改善了行为和心理症状。但是，尽管研究小组在神经精神库存评分方面存在显着差异，但我们没有发现在功能下降中组之间存在显着差异。两个研究小组在18个月内的功能均大幅下降。当前的研究建议测试一种基于家庭的干预措施，该干预措施专门设计，以减慢阿尔茨海默氏病老年人的功能下降速度。除了基于我们过去的研究，这项研究还基于最近报道的研究，该研究表明，家庭痴呆症老年人的家庭职业治疗干预措施的短期疗效。这些试验表明，包括阿尔茨海默氏病在内的痴呆症老年人都可以参与并受益于家庭提供的基于职业治疗的干预措施。这项研究的具体目的是进行两年，随机的，对照临床试验，以通过比较接受最佳实践的对照组与接受最佳初级保健以及基于家庭职业治疗的干预组的对照组进行比较，以改善患有阿尔茨海默氏病的老年人的功能。我们将测试主要假设，即与最佳实践初级保健对照组相比，干预组中患有阿尔茨海默氏病的受试者将在两年内提高功能。公共卫生相关性：超过400万美国人患有阿尔茨海默氏病，即使在新疗法有效性的乐观情况下，这一数字将在未来几十年中三倍。因此，迫切需要在社区为社区提供纵向护理的有效方法。