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Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial

Paul Clarkson Orcid Logo, Rosa Pitts, Saiful Islam Orcid Logo, Julie Peconi, Ian Russell Orcid Logo, Greg Fegan, Rebecca Beresford, Charlotte Entwistle, Vincent Gillan, Martin Orrell, David Challis Orcid Logo, Helen Chester, Jane Hughes, Narinder Kapur, Brenda Roe, Baber Malik, Catherine Robinson

Journal of Neurology, Neurosurgery & Psychiatry, Volume: 93, Issue: 9, Pages: 1001 - 1009

Swansea University Authors: Saiful Islam Orcid Logo, Julie Peconi, Ian Russell Orcid Logo, Greg Fegan

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DOI (Published version): 10.1136/jnnp-2021-326748

Abstract

Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued. To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a prag...

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Published in: Journal of Neurology, Neurosurgery & Psychiatry
ISSN: 0022-3050 1468-330X
Published: BMJ 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa58545
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However, rigorous evaluation is lacking, particularly what guidance or support is valued. To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial. Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ). DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: -0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers. Current Controlled Trials ISRCTN12591717. [Abstract copyright: &#xA9; Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. 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spelling 2022-09-09T14:55:57.1769814 v2 58545 2021-11-03 Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial 4157d27b800a8357873bdfc9c71bd596 0000-0003-3182-8487 Saiful Islam Saiful Islam true false 55cdaf988e981df96182ece79762a3cf Julie Peconi Julie Peconi true false 07f8ce1304fdfe94981330301c2b3977 0000-0002-0069-479X Ian Russell Ian Russell true false a9005418b89918776f3d8895ba42e850 Greg Fegan Greg Fegan true false 2021-11-03 HDAT Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued. To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial. Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ). DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: -0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers. Current Controlled Trials ISRCTN12591717. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.] Journal Article Journal of Neurology, Neurosurgery &amp; Psychiatry 93 9 1001 1009 BMJ 0022-3050 1468-330X AIDS, dementia, memory 12 8 2022 2022-08-12 10.1136/jnnp-2021-326748 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University DTC-RP-PG-0311-12003 2022-09-09T14:55:57.1769814 2021-11-03T17:16:07.1930007 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Paul Clarkson 0000-0002-0778-312x 1 Rosa Pitts 2 Saiful Islam 0000-0003-3182-8487 3 Julie Peconi 4 Ian Russell 0000-0002-0069-479X 5 Greg Fegan 6 Rebecca Beresford 7 Charlotte Entwistle 8 Vincent Gillan 9 Martin Orrell 10 David Challis 0000-0002-6464-2286 11 Helen Chester 12 Jane Hughes 13 Narinder Kapur 14 Brenda Roe 15 Baber Malik 16 Catherine Robinson 17 58545__21425__3ece7e765ec74147a9af3b807fdd9a8b.pdf 58545.pdf 2021-11-03T17:33:21.4179972 Output 424135 application/pdf Accepted Manuscript true Released under the terms of a CC BY-NC 4.0 license true eng https://creativecommons.org/licenses/by-nc/4.0/
title Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
spellingShingle Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
Saiful Islam
Julie Peconi
Ian Russell
Greg Fegan
title_short Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
title_full Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
title_fullStr Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
title_full_unstemmed Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
title_sort Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
author_id_str_mv 4157d27b800a8357873bdfc9c71bd596
55cdaf988e981df96182ece79762a3cf
07f8ce1304fdfe94981330301c2b3977
a9005418b89918776f3d8895ba42e850
author_id_fullname_str_mv 4157d27b800a8357873bdfc9c71bd596_***_Saiful Islam
55cdaf988e981df96182ece79762a3cf_***_Julie Peconi
07f8ce1304fdfe94981330301c2b3977_***_Ian Russell
a9005418b89918776f3d8895ba42e850_***_Greg Fegan
author Saiful Islam
Julie Peconi
Ian Russell
Greg Fegan
author2 Paul Clarkson
Rosa Pitts
Saiful Islam
Julie Peconi
Ian Russell
Greg Fegan
Rebecca Beresford
Charlotte Entwistle
Vincent Gillan
Martin Orrell
David Challis
Helen Chester
Jane Hughes
Narinder Kapur
Brenda Roe
Baber Malik
Catherine Robinson
format Journal article
container_title Journal of Neurology, Neurosurgery &amp; Psychiatry
container_volume 93
container_issue 9
container_start_page 1001
publishDate 2022
institution Swansea University
issn 0022-3050
1468-330X
doi_str_mv 10.1136/jnnp-2021-326748
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued. To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial. Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ). DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: -0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers. Current Controlled Trials ISRCTN12591717. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.]
published_date 2022-08-12T04:15:09Z
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