Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers. (9th October 2018)

• Record Type: Journal Article
• Authors: Teri, Linda; Logsdon, Rebecca G; McCurry, Susan M; Pike, Kenneth C; McGough, Ellen L
• Editors: Meeks, Suzanne
• Is Part Of: Gerontologist. Volume 60:Number 3(2020)
• Page Start: 548
• Page End: 557
• Publication Date: 2018-10-09
• Subjects: Exercise/physical activity -- Behavior management -- Home and community-based care and services -- RDAD; Older people -- Periodicals; Older people -- United States -- Periodicals; 305.2605
• DOI: 10.1093/geront/gny122
• Languages: English
• ISSNs: 0016-9013

Abstract

Abstract: Background and Objectives: Effective community-based programs to maintain health and well-being of adults with dementia are needed. This article describes the translation, implementation, and effectiveness of a multicomponent exercise plus behavioral/psychosocial intervention (Reducing Disability in Alzheimer's Disease-NorthWest [RDAD-NW]) conducted by staff in regional Area Agencies on Aging (AAAs). Research Design and Methods: Staggered multiple baseline design was used; 10 AAAs, 20 case managers, and 255 community-residing persons with dementia (PWDs), and family caregivers were enrolled. RDAD-NW was conducted in-home over 6 weeks with aerobic/endurance, strength, and balance/flexibility exercises, dementia education, training to increase pleasant events, and activator-behavior-consequence problem-solving approach. Outcomes included case manager treatment fidelity, and caregiver/PWD physical activity, restricted activity days, physical functioning, quality of life, and affect. Results: RDAD-NW was successfully translated and implemented by AAA agency staff through their usual service provision mechanisms. Staff responded positively and delivered the program with a high degree of fidelity. Caregiver/PWD dyads also responded favorably engaging in both exercise and behavioral/psychosocial portions of the program. A total of 207 dyads (81%) completed the intervention and 140 (55%) completed the 13-month follow-up. PWD physical activity increased significantly pre- to posttreatment ( p < .001, ES = .54), and 13 months ( p < .01, ES = .21). Quality of life of PWD increased significantly pre- to posttreatment ( p < .001, ES = .29); caregiver depression improved pre- to posttreatment ( p = .01, ES = −.18). Discussion and Implications: RDAD-NW was successfully translated and implemented by AAA case managers and resulted in increased physical activity and improved behavioral and emotional outcomes of caregiver/PWDs. Results support continued dissemination and implementation of RDAD-NW. Clinical Trials Registration: NCT01708304