Depression in People With Dementia and Caregiver Outcomes: Results From the European Right Time Place Care Study

Parrotta, Ilaria; Mauléon, Adélaïde De; Abdeljalil, Anne-Bahia; Barreto, Philipe de Souto; Lethin, Connie; Veerbek, Hilde; Stephan, Astrid; Saks, Kai; Zabalegui, Adelaida; Martín, María

doi:10.1016/j.jamda.2020.02.023

Cited by 7 publications

(13 citation statements)

References 44 publications

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“…Table 2 summarizes the eight observational and RCT studies informing the type of study, setting, age, dementia stage, research methods and main conclusions. Seven studies [ 35 – 40 ] defined dementia disease with the Mini Mental State Examination Scale (MMSE) (range: 0–30) [ 41 ]. One study, by Sköldunger et al [ 42 ], used the Global Deterioration Scale for assessment of primary degenerative dementia (GDS) (range: 1–7) [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study, by Sköldunger et al [ 42 ], used the Global Deterioration Scale for assessment of primary degenerative dementia (GDS) (range: 1–7) [ 43 ]. Among the studies in a home-dwelling setting [ 35 – 38 , 40 , 44 ] there was no specified dementia disease in all 7 studies. There was one RCT study by Luttenberger et al [ 39 ] ( n = 119) that followed caregivers for persons accommodated in nursing homes within a six-month period.…”

Section: Resultsmentioning

confidence: 99%

“…A strength of the study was the comparison with formal care. Parrota et al [ 40 ] found a 1.7 increase in supervision hours per day when PwD had depressive symptoms. Depression was defined with the Cornell Scale for Depression in Dementia (CSDD) [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…A strength of the study was the use of all three parts of RUD assessing hours per month; supervision, IADL and ADL, and the analyses incorporated a comparison of the effect of different psychotropic medication to different NPI-symptoms (items) as an alternative analysis. Among the eight non-cost evaluation studies, one study used RUD-FOCA [ 39 ], five studies used all measurements of RUD [ 36 – 38 , 42 ], one study, by Teipel et al [ 35 ] excluded supervision, and one study only, by Parrotta et al [ 40 ], used supervision.…”

Section: Resultsmentioning

confidence: 99%

“… Luttenberger et al (2012) Germany [ 39 ] Cross-sectional, longitudinal Nursing home; 84.7; MMSE 15.2 Regression 160 MMSE The 6-month non-pharmacological intervention improved dementia symptoms in nursing home residents, especially in social behavior and IADL capabilities, but no effect was seen on informal care time. Parrotta et al (2020) Cross-country f [ 40 ] Cross-sectional Community-dwelling; 81.9 (62); MMSE 12.5 Regression 1223 MMSE Depression in PwD is associated with an increased burden and distress of informal caregivers and a reduction of their quality of life. PwD people with dementia, CG caregivers.…”

Section: Resultsmentioning

confidence: 99%

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Which factors increase informal care hours and societal costs among caregivers of people with dementia? A systematic review of Resource Utilization in Dementia (RUD)

et al. 2021

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Background Nearly 19 million people across OECD countries are living with dementia, and millions of family caregivers are affected by the disease. The costs of informal care are estimated to represent 40–75% of the total dementia cost exceeding formal care time and medical costs. Objective To conduct a systematic review to evaluate the methodological quality and factors associated with high informal care hours per month that increase societal costs, and to identify what type of interventions may alleviate the entire burden of informal and formal caregiving. Methods The systematic review was registered at PROSPERO (15.12.2020). A search in Medline, Embase, PsycINFO, and web of science for observational studies, cost-effectiveness, and cost of illness (COI) analyses on resource utilization in dementia (RUD) was conducted on 1 December 2020. Our inclusion criteria included a requirement that studies had to use the original RUD, RUD-FOCA or RUD lite in terms of hours or days per month, and costs as primary or secondary outcome, OECD countries, within the last 20 years and a sample population comprising persons with dementia (PwD) ≥65 years and their caregivers. We followed the PRISMA, GRADE, PICO guidelines and Drummond criteria to assess the methodology and quality of the studies. Results Of 307 studies, 26 cross-sectional and 3 longitudinal cohort studies were included in the analyses. Two studies had a randomized controlled trial (RCT) design. The methods and cost categories in each study varied widely. Disease severity, caregiver factors, and behavioural and psychological symptoms of dementia (BPSD) were associated with high informal care hours and societal cost. One RCT found no effect of a non-pharmacological intervention on informal care hours, yet another RCT found a cost-effective impact of an in-home respite care programme reducing informal care burden and costs. Conclusion The divergent use of the RUD components within included studies encourage more harmonized analyses. There are only two RCTs on RUD, one of which shows a significant treatment effect. Larger sample sizes and longer follow-up periods are required in future RCTs with dedicated focus on cost-enhancing and resource intensive factors such as disease severity and BPSD. Novel interventions must diversify between caregiver and PwD groups. PROSPERO registration CRD42021226388.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Which factors increase informal care hours and societal costs among caregivers of people with dementia? A systematic review of Resource Utilization in Dementia (RUD)

et al. 2021

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Prevalence, treatment, and neural correlates of apathy in different forms of dementia: a narrative review

Parrotta,

Cacciatore,

D’Andrea

et al. 2023

Neurol Sci

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Objectives The aim of this review is to provide an overview on prevalence and clinical tools for the diagnosis of apathy, as well as on neurophysiological and neuroimaging findings obtained from studies in patients with apathy in different forms of dementia, including Alzheimer’s disease (AD), vascular (VaD) and mixed dementia, frontotemporal dementia (FTD), and Parkinson’s disease dementia (PDD). Methods Randomized controlled trials, non-randomized controlled trials, controlled before–after studies, and interrupted time series from four databases (WebOfScience, Scopus, Pubmed, and PsycINFO) addressing apathy in adults or older people aged over 65 years of age affected by dementia were included. Results The prevalence of apathy was 26–82% for AD, 28.6–91.7 for VaD, 29–97.5% in PDD, and 54.8–88.0 in FTD. The assessment of apathy was not consistent in the reviewed studies. Methylphenidate was the most successful pharmacological treatment for apathy. Neurobiological studies highlighted the relationship between both structural and functional brain areas and the presence or severity of apathy. Conclusion Apathy is a very common disorder in all types of dementia, although it is often underdiagnosed and undertreated. Further studies are needed to investigate its diagnosis and management. A consensus on the different evaluation scales should be achieved.

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Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

Signore¹,

Zia²,

Abbatecola

et al. 2023

Eur Geriatr Med

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Key summary points Aim To comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants in a large dataset from the GeroCovid Observational multiscope and multisetting study. Findings 10.8% out of 3396 persons included used trazodone and the 8.5% other antidepressants; the use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to long-term care facilities or living at home. Conditions associated with trazodone use included depression, dementia and behavioral and psychological symptoms of dementia. Message The present data suggest an off-label use of trazodone as a possible therapeutic option in the challenging field of behavioral and psychological disturbances in older adults with dementia.

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Depression in People With Dementia and Caregiver Outcomes: Results From the European Right Time Place Care Study

Cited by 7 publications

References 44 publications

Which factors increase informal care hours and societal costs among caregivers of people with dementia? A systematic review of Resource Utilization in Dementia (RUD)

Which factors increase informal care hours and societal costs among caregivers of people with dementia? A systematic review of Resource Utilization in Dementia (RUD)

Prevalence, treatment, and neural correlates of apathy in different forms of dementia: a narrative review

Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study

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