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)

Abstract

ObjectivesTo 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.DesignMulticentre, randomised, controlled, rater-blinded trial.SettingPrimary care and memory clinics in five Danish districts.Participants330 home-dwelling patients with mild Alzheimer's disease and their primary caregivers (dyads).InterventionsDyads 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 measuresPrimary 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.ResultsAt 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.ConclusionsFor 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 registrationThe study was registered in the Clinical Trial Database (http://www.controlled-trials.com/ISRCTN74848736).

Effectiveness of Supporting Informal Caregivers of People with Dementia: A Systematic Review of Randomized and Non-Randomized Controlled Trials

“…It refers to a balance between the social, physical, and psychological resources caregivers need in order to meet their social, psychological, and physical challenges [18][19][20][21]. Although many interventions demonstrated positive impacts on different outcomes such as burden [22,23], quality of life of the caregiver [24], and delay in hospitalization [25]; other similar studies did not find the same benefits [26][27][28]. Inconsistency of the current findings can be explained by the methodological issues caused by the complex nature of this type of research, e.g., [4,[29][30][31][32][33][34][35], such as: different duration of interventions, different intensity and characteristics of interventions, and the variety of caregivers and care-recipients characteristics.…”

“…After 36 months the earlier found benefits did not remain. The other investigated outcomes did not improve or decrease [28].…”

The influence of the individual neuropsychiatric symptoms of people with Alzheimer disease on family caregiver distress—A longitudinal ALSOVA study

“…At the baseline, all cases of AD were classified as very mild or mild, which had progressed to mild or moderate AD by the end of the follow‐up period. The dropout rate was quite high, although it is comparable with other studies of this population . LMM models were used in the statistical analyses, which allow the use of all available longitudinal data, to avoid the associated bias.…”

Individual and group psychotherapy with people diagnosed with dementia: a systematic review of the literature

“…The standard of reporting of papers was of mixed quality. For example, whilst the DAISY study (Waldorf et al , 2012; Phung et al ., ) in particular stood out for its methodological rigour, other studies including Hirazakura et al . () and Tondi et al .…”