Biobehavioral Approach Linked to Benefits in Dementia

Intervention aimed at patients, caregivers includes visits with therapists, advance practice nurses

01 sept 2010-- A biobehavioral environmental intervention -- Care of Persons with Dementia in their Environments (COPE) -- is associated with better functioning in patients with dementia after four months, as well as benefits for caregivers, according to research published in the Sept. 1 issue of the Journal of the American Medical Association.

Laura N. Gitlin, Ph.D., of Thomas Jefferson University in Philadelphia, and colleagues analyzed data from 209 pairs of patients and their family caregivers. Participants were randomized to receive up to 12 contacts in the home or over the phone with occupational therapists and an advanced practice nurse who provided training to caregivers on matters such as modifying the home environment and daily activities. Control caregivers received educational materials and up to three calls from research staff.

The researchers found that the COPE group had less functional dependence at four months and less dependence in instrumental activities of daily living compared with controls. COPE patients also had improved engagement, and their caregivers had improved well-being and improved confidence using activities. At nine months, changes in outcomes were similar for patients in the two groups, but COPE caregivers reported greater benefits.

"Because most patients live at home with functional decline, a non-pharmacologic, biopsychosocial-environmental intervention may positively contribute to disease management. Future research needs to examine effects of underlying medical conditions, ways to boost treatment effects, cost-effectiveness, COPE in combination with pharmacologic treatments, and translational potential," the authors conclude.