A three-year follow-up on the efficacy of psychosocial interventions for patients with mild dementia and their caregivers: the multicentre, rater-blinded, randomised Danish Alzheimer Intervention Study (DAISY). Issue 11 (21st November 2013)

• Record Type: Journal Article
• Authors: Phung, Kieu T T; Waldorff, F B; Buss, D V; Eckermann, A; Keiding, N; Rishøj, S; Siersma, V; Sørensen, J; Søgaard, R; Sørensen, L V; Vogel, A; Waldemar, G
• Is Part Of: BMJ open. Volume 3:Issue 11(2013)
• Publication Date: 2013-11-21
• Subjects: Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2013-003584
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To examine the long-term efficacy at the 36-month follow-up of an early psychosocial counselling and support programme lasting 8–12 months for community-dwelling patients with mild Alzheimer's disease and their caregivers. Design: Multicentre, randomised, controlled, rater-blinded trial. Setting: Primary care and memory clinics in five Danish districts. Participants: 330 home-dwelling patients with mild Alzheimer's disease and their primary caregivers (dyads). Interventions: Dyads were randomised to receive intervention during the first year after diagnosis. Both intervention and control groups had follow-up visits at 3, 6, 12 and 36 months. Main outcome measures: Primary outcomes for the patients assessed at 36-month follow-up were changes from baseline in global cognitive function (Mini-Mental State Examination), depressive symptoms (Cornell Depression Scale) and proxy-rated EuroQoL quality of life on visual analogue scale. The primary outcomes for the caregivers were changes from baseline in depressive symptoms (Geriatric Depression Scale) and self-rated EuroQoL quality of life on a visual analogue scale. The secondary outcome measures for the patient were proxy-rated Quality of Life Scale for Alzheimer's disease (QoL-AD), Neuropsychiatric Inventory-Questionnaire, Alzheimer's disease Cooperative Study Activities of Daily Living Scale, all-cause mortality and nursing home placement. Results: At a 36-month follow-up, 2 years after the completion of the Danish Alzheimer Intervention Study (DAISY), the unadjusted positive effects previously detected at the 12-month follow-up in one patient primary outcome (Cornell depression score) and one patient secondary outcome (proxy-rated QoL-AD) disappeared (Cornell depression score, p=0.93; proxy-rated QoL-AD, p=0.81). No long-term effect of DAISY intervention on any other primary and secondary outcomes was found at the 36-month follow-up. Conclusions: For patients with very mild Alzheimer's disease and their caregivers, an intensive, multi-component, semitailored psychosocial intervention programme with counselling, education and support during the first year after diagnosis did not show any positive long-term effect on primary and secondary outcomes. Trial registration: The study was registered in the Clinical Trial Database (http://www.controlled-trials.com/ISRCTN74848736 ).