Contribution of a Psycho-Educational Program of Help to Help in the Pharmacological Assumption of Responsibility of the Disease of Alzheimer
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Alzheimer's Disease
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 240
- Locations
- 1
- Primary Endpoint
- DAD scale (Disability Assessment for Dementia)
- Status
- Completed
- Last Updated
- 15 years ago
Overview
Brief Summary
The aim of the project is to demonstrate that a psycho-educational programme designed to support and train carers of Alzheimer's disease (AD) patients induces a significantly higher benefit than anticholinesterase drug treatment alone or associated to memantine treatment. This training programme focuses on the explanation/description of behavioral, cognitive and functional disorders induced by the disease, as well as principles of cognitive and psycho-social stimulation of the patients in daily life.
Detailed Description
Context: Research showing the benefit of a combined approach including specific antidementia drugs and psycho-educational programmes for caregivers in the caring of Alzheimer's disease patients is still lacking. We venture the hypothesis that combined treatment including a specific antidementia drug for the AD patient and a psycho-educational programme for the caregivers has a larger benefit for both the patient and the caregiver on psychological, behavioural, and cognitive parameters. Main objective: to demonstrate that a psycho-educational programme designed to support and train carers of Alzheimer's disease (AD) patients induces a significantly higher benefit than anticholinesterase drug treatment alone or associated to memantine treatment. Secondary objective: identify patterns of responders and non-responders (taking into account cognitive, psychological parameters). Methodology: national multicentric, randomized trial, single blinded, with 2 parallel groups of 120 patients and 120 caregivers trained for a 3 month period with 3 assessments: before, just after and 3 months after the training period. Patients and caregivers are recruited (according to exclusion and inclusion criteria) and followed up in memory centers participating in the trial. Evaluation criteria: Primary criteria for the patient: DAD scale (Disability Assessment for Dementia). Secondary evaluation criteria - for the patient: NPI and ADAS-Cog; for the caregiver: ZARIT scale, Questionnaire of feeling of competency, Montgomery and Asberg Depression Rating Scale (MADRS), Geriatric Depression Scale (GDS). Statistical analysis by the department of biostatistics and medical computing of the Hospital Cochin will be performed.
Investigators
Eligibility Criteria
Inclusion Criteria
- •AD outpatients
- •Stable pharmacological treatment
- •Mini-Mental State Examination (MMSE) \[10 -28\]
- •Age \[60-90\]
- •Informed consent
- •Caregivers:
- •Reliability
- •Motivation
- •Psychological disorder related to patient's disease
- •Need for information or help
Exclusion Criteria
- •Other dementia
- •Severe general disease
- •No reliable caregiver
- •Caregivers:
- •Physical or mental disease incompatible with patient's management
- •Impossibility to participate in the educational program
- •Absence of anxiety-depression
- •Psychotherapy
Outcomes
Primary Outcomes
DAD scale (Disability Assessment for Dementia)
Time Frame: at 6 months
Secondary Outcomes
- cardiovascular mortality(at 6 months)
- functional status(at 4 weeks)
- for the patient: NPI and ADAS-Cog(during the study)
- for the caregiver: ZARIT scale, questionnaire of feeling of competency, Montgomery and Asberg Depression Rating Scale (MADRS), Geriatric Depression Scale (GDS)(during the study)
- all cause mortality(at one year)
- score on a depression rating scale(at 6 weeks)