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Clinical Trial
. 2020 Apr 2;60(3):548-557.
doi: 10.1093/geront/gny122.

Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers

Linda Teri  1 , Rebecca G Logsdon  1 , Susan M McCurry  1 , Kenneth C Pike  2 , Ellen L McGough  3
Affiliations
Clinical Trial

Translating an Evidence-based Multicomponent Intervention for Older Adults With Dementia and Caregivers

Linda Teri et al. Gerontologist. .

Abstract

Background and objectives: Effective community-based programs to maintain health and well-being of adults with dementia are needed. This article describes the translation, implementation, and effectiveness of a multicomponent exercise plus behavioral/psychosocial intervention (Reducing Disability in Alzheimer's Disease-NorthWest [RDAD-NW]) conducted by staff in regional Area Agencies on Aging (AAAs).

Research design and methods: Staggered multiple baseline design was used; 10 AAAs, 20 case managers, and 255 community-residing persons with dementia (PWDs), and family caregivers were enrolled. RDAD-NW was conducted in-home over 6 weeks with aerobic/endurance, strength, and balance/flexibility exercises, dementia education, training to increase pleasant events, and activator-behavior-consequence problem-solving approach. Outcomes included case manager treatment fidelity, and caregiver/PWD physical activity, restricted activity days, physical functioning, quality of life, and affect.

Results: RDAD-NW was successfully translated and implemented by AAA agency staff through their usual service provision mechanisms. Staff responded positively and delivered the program with a high degree of fidelity. Caregiver/PWD dyads also responded favorably engaging in both exercise and behavioral/psychosocial portions of the program. A total of 207 dyads (81%) completed the intervention and 140 (55%) completed the 13-month follow-up. PWD physical activity increased significantly pre- to posttreatment (p < .001, ES = .54), and 13 months (p < .01, ES = .21). Quality of life of PWD increased significantly pre- to posttreatment (p < .001, ES = .29); caregiver depression improved pre- to posttreatment (p = .01, ES = -.18).

Discussion and implications: RDAD-NW was successfully translated and implemented by AAA case managers and resulted in increased physical activity and improved behavioral and emotional outcomes of caregiver/PWDs. Results support continued dissemination and implementation of RDAD-NW.

Clinical trials registration: NCT01708304.

Keywords: Behavior management; Exercise/physical activity; Home and community-based care and services; RDAD.

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Figures

Figure 1.
Figure 1.
Flow of PWDs and Caregivers Through the Study
Figure 2.
Figure 2.
Exercise Days for PWDs and Caregivers
See this image and copyright information in PMC

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