Premium
Individualized Cognition‐Action intervention to prevent behavioral disturbances and functional decline in institutionalized older adults: a randomized pilot trial
Author(s) -
Dechamps Arnaud,
Alban Rigier,
Jen Joanne,
Decamps Arnaud,
Traissac Thalie,
Dehail Patrick
Publication year - 2010
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2427
Subject(s) - geriatric depression scale , randomized controlled trial , medicine , intervention (counseling) , physical therapy , quality of life (healthcare) , berg balance scale , cognition , geriatrics , depression (economics) , balance (ability) , depressive symptoms , psychiatry , nursing , economics , macroeconomics
Objective To evaluate the effectiveness of an individualized Cognition‐Action (CA) intervention to reduce behavioral disturbances in severely deconditioned institutionalized old adults. Design 12 weeks randomized pilot trial of either individualized Cognition‐Action program ( n = 24) or routine medical care as control (C, n = 25). Setting Long‐term care (LTC) of the Geriatric Department from the University State Hospital in Bordeaux, France. Participants 49 institutionalized old patients with at least one Neuropsychiatric symptoms ≥4. Intervention The CA rationale was a non‐preconceived ideas approach over the patient's abilities and discourse. Patients received short bouts of 5–15 min and accumulated 50 min of interaction per week. CA intervention used five standardized exercises as tools to enhance communication and social interactions. CA was compared to usual care. Measurements Primary outcomes were the Neuropsychiatric inventory (NPI) total and symptoms scores. Secondary outcomes were the BERG balance scale, the Geriatric Depression Scale (GDS), Quality of life AM‐PAC‐CAT and Muscle strength. Results The CA group had a clinically significant NPI total score reduction compared to C, −7, 95%CI [−10.8 to −3], $\eta _p^{\rm 2} $ = 0.24. CA group showed a risk reduction of NPI total score worsening, OR = 0.09, 95%CI [0.02–0.37]. BERG total score was clinically improved in the CA group compared to C, 4.9 95%CI [0.7–9.2], $\eta _p^{\rm 2} $ = 0.11. CA patients reduced their GDS score and improved their Quality of life and Strength. Conclusions The combination of tailored guidance and simple standardized exercises was an effective behavioral management approach for behavioral disturbances reduction and functional autonomy improvement in institutionalized old adult populations. Copyright © 2009 John Wiley & Sons, Ltd.