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：
7987916
负责人：
CHRISTOPHER M CALLAHAN
金额：
$ 59.21万
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/7987916
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 Environment Equipment and supply inventories Family Caregiver Goals Guidelines Hand Health Healthcare Home environment Hospitalization Impaired cognition Institutionalization Intervention Intervention Trial Learning Literature Medical Mental Health Methods Modeling Nursing Homes 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 cost design disability experience functional decline group intervention improved improved functioning neuropsychiatry patient home care patient oriented patient population primary care setting 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）：拟议的研究建立在我们之前的临床试验结果的基础上，该试验证明了协作护理对于初级护理实践中护理的患有阿尔茨海默病的老年人的有效性。在之前的试验中，我们证明指南水平的医疗护理在一年多的时间里提高了患者及其护理人员的护理质量并改善了行为和心理症状。然而，尽管发现研究组之间的神经精神量表评分存在显着差异，但我们没有发现各组之间的功能下降存在显着差异。两个研究组在 18 个月内都经历了功能显着下降。目前的研究计划测试一种专门设计用于减缓患有阿尔茨海默病的老年人功能衰退速度的家庭干预措施。除了以我们过去的研究为基础之外，该研究还以最近报道的研究为基础，这些研究证明了家庭职业治疗干预措施对患有痴呆症的老年人的短期疗效。这些试验表明，患有痴呆症（包括阿尔茨海默病）的老年人可以参与在家中进行的基于职业治疗的干预措施并从中受益。本研究的具体目的是进行一项为期两年的随机对照临床试验，通过将接受最佳实践初级保健的对照组与接受最佳实践初级保健加家庭护理的干预组进行比较，以改善患有阿尔茨海默病的老年人的功能基于职业治疗的干预。我们将检验主要假设，即与最佳实践初级保健对照组相比，干预组中的阿尔茨海默病受试者在两年后功能会有所改善。公共健康相关性：超过 400 万美国人患有阿尔茨海默病，即使在新疗法有效性的乐观情况下，这个数字在未来几十年内仍将增加两倍。因此，迫切需要有效的方法在社区中为这一迅速增长的人口提供纵向护理。