Health and nutrition promotion program for patients with dementia (NutriAlz): cluster randomized trial
- PMID: 22159768
- PMCID: PMC12878007
- DOI: 10.1007/s12603-011-0363-3
Health and nutrition promotion program for patients with dementia (NutriAlz): cluster randomized trial
Abstract
Objective: To assess the effectiveness of health and nutrition program (NutriAlz) versus usual care on functional level in elderly people with dementia living at home, as well as on clinical practice related to nutrition and on the caregiver's burden.
Design: Cluster randomized multi-centre study with one-year follow-up.
Setting: 11 Alzheimer outpatients and day care centres (Barcelona, Spain).
Participants: Nine hundred and forty six home-living Alzheimer patients with identified caregiver were consecutively recruited (intervention group: 6 centres, 448 patients vs control group: 5 centres, 498 patients).
Intervention: The intervention was a teaching and training intervention on health and nutrition program, NutriAlz, directed both to physician and main caregiver, as well as persons affected by Alzheimer's disease or other dementias, including a standardised protocol for feeding and nutrition.
Main outcome measures: The main outcome measure was the reduction in the loss of autonomy (Activities of daily living (ADL/IADL) scales) assessed at 6 and 12 months. Secondary outcomes measures were Improvement in nutritional status (Mini Nutritional Assessment (MNA), BMI, and weight changes), and caregiver burden (Zarit scale).
Results: The one-year assessment was completed for 293 patients (65.4%) in the intervention group and 363 patients (72.9%) in the control group (usual care). The annual rate of ADL change was -0.83 vs -0.62 (p=0.984), and the caregiver's subjective burden 0.59 vs 2.36 (p=0.681) in intervention and control group, respectively. MNA, however, showed an improvement (+0.46 vs -0.66, p=0.028), suggesting an effective nutritional behaviour.
Conclusion: The NutriAlz program had no effect on functional decline in Alzheimer disease patients living at home over one year, but reduced the risk for malnutrition, as recommendations concerning diet and exercise were provided.
Trial registration: ClinicalTrials.gov NCT00479843.
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References
-
- Berr C., Wancata J., Ritchie K. Prevalence of dementia in the elderly in Europe. Eur Neuropsychopharmacol. 2005;15(4):463–471. 10.1016/j.euroneuro.2005.04.003 PubMed PMID: 15955676. - DOI - PubMed
-
- Thompson C., Spilsbury K., Hall J., Birks Y., Barnes C., Adamson J. Systematic review of information and support interventions for caregivers of people with dementia. BMC Geriatrics. 2007;7(1):18. 10.1186/1471-2318-7-18 PubMed PMID: 17662119. - DOI - PMC - PubMed
-
- Mittelman M.S., Ferris S.H., Shulman E., Steinberg G., Levin B. A family intervention to delay nursing home placement of patients with Alzheimer disease. A randomized controlled trial. JAMA: The Journal of the American Medical Association. 1996;276(21):1725–1731. 10.1001/jama.1996.03540210033030 - DOI - PubMed
-
- Mittelman M.S., Haley W.E., Clay O.J., Roth D.L. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology. 2006;67(9):1592–1599. 10.1212/01.wnl.0000242727.81172.91 PubMed PMID: 17101889. - DOI - PubMed
Uncited references
-
- Bermejo-Pareja F., ito-Leon J., Vega S., Medrano M.J., Roman G.C. Incidence and subtypes of dementia in three elderly populations of central Spain. Journal of the Neurological Sciences. 2008;264(1–2):63–72. 10.1016/j.jns.2007.07.021 PubMed PMID: 17727890. - DOI - PubMed
-
- Ferri C.P., Prince M., Brayne C., Brodaty H., Fratiglioni L., Ganguli M., et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–2117. 10.1016/S0140-6736(05)67889-0 PubMed PMID: 16360788. - DOI - PMC - PubMed
-
- Matthews F., Brayne C. The incidence of dementia in England and Wales: findings from the five identical sites of the MRC CFA Study. PLoS Med. 2005;2(8):e193. 10.1371/journal.pmed.0020193 PubMed PMID: 16111436. - DOI - PMC - PubMed
-
- Devor M., Renvall M. An educational intervention to support caregivers of elders with dementia. Am J Alzheimers. Dis Other Demen. 2008;23(3):233–241. 10.1177/1533317508315336 - DOI - PMC - PubMed
-
- Leone E., Deudon A., Robert P. Physical activity, dementia, and BPSD. J Nutr Health Aging. 2008;12(7):457–460. 10.1007/BF02982706 PubMed PMID: 18615227. - DOI - PubMed
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