TY - JOUR
T1 - Dementia Early Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia
T2 - randomised controlled trial
AU - Clarkson, Paul
AU - Pitts, Rosa
AU - Islam, Saiful
AU - Peconi, Julie
AU - Russell, Ian
AU - Fegan, Greg
AU - Beresford, Rebecca
AU - Entwistle, Charlotte
AU - Gillan, Vincent
AU - Orrell, Martin
AU - Challis, David
AU - Chester, Helen
AU - Hughes, Jane
AU - Kapur, Narinder
AU - ROE, BRENDA
AU - Malik, Baber
AU - Robinson , Catherine
PY - 2021/10/19
Y1 - 2021/10/19
N2 - BACKGROUNDCommon memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued.OBJECTIVETo investigate effects of memory aids and guidance by Dementia Support Practitioners (DSPs) for people in early stage dementia through a pragmatic, randomised controlled trial.METHODSOf 469 people with mild to moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by: Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; SMMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ).RESULTSDSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS score increased to 14.6 (SD 10.4) in intervention and 12.6 (SD 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between group difference was 0.38 (95% confidence interval -0.89 to 1.65, P=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. CONCLUSIONSThis intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers.
AB - BACKGROUNDCommon memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued.OBJECTIVETo investigate effects of memory aids and guidance by Dementia Support Practitioners (DSPs) for people in early stage dementia through a pragmatic, randomised controlled trial.METHODSOf 469 people with mild to moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by: Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; SMMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ).RESULTSDSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS score increased to 14.6 (SD 10.4) in intervention and 12.6 (SD 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between group difference was 0.38 (95% confidence interval -0.89 to 1.65, P=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. CONCLUSIONSThis intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers.
KW - Dementia
U2 - 10.1136/jnnp-2021-326748
DO - 10.1136/jnnp-2021-326748
M3 - Article (journal)
SN - 0022-3050
SP - 1
EP - 9
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
ER -
