Dementia Early Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial

Paul Clarkson*, Rosa Pitts, Saiful Islam, Julie Peconi, Ian Russell, Greg Fegan, Rebecca Beresford, Charlotte Entwistle, Vincent Gillan, Martin Orrell, David Challis, Helen Chester, Jane Hughes, Narinder Kapur, BRENDA ROE, Baber Malik, Catherine Robinson

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

Abstract


BACKGROUND
Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued.

OBJECTIVE
To investigate effects of memory aids and guidance by Dementia Support Practitioners (DSPs) for people in early stage dementia through a pragmatic, randomised controlled trial.

METHODS
Of 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).

RESULTS
DSPs 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.

CONCLUSIONS
This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers.
Original languageEnglish
Pages (from-to)1-9
JournalJournal of Neurology, Neurosurgery and Psychiatry
Early online date19 Oct 2021
DOIs
Publication statusE-pub ahead of print - 19 Oct 2021

Keywords

  • Dementia

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