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279 active trials for Dementia

Virtual Chair Yoga for Older Adults and Caregivers: Randomized Controlled Trial

Over 700,000 Canadians are affected by dementia costing the health care system approximately $10 billion/year. Due to COVID-19, the government has urged individuals over the age of 70 to stay home, putting this population at risk of social isolation. Older adults with mild cognitive impairments (MCIs), dementia, and their caregivers are at an even higher risk of becoming stressed, anxious, and agitated while in lockdown. Unsurprisingly, caregiver burden is extremely common, and often precedes institutionalization of the patient, as the demands of the illness begin to exceed that which the caregiver can sustainably provide. Since social distancing measures have shut down activities and support groups for these individuals, there is an urgent need for scalable, cost-effective, non-pharmacological interventions that can be delivered remotely to improve stress and loneliness. Yoga may be a viable therapeutic modality to address the psychological challenges associated with dementia in patients and caregivers, as it has been shown to decrease stress and improve anxiety and depressive symptoms in various populations. For this reason, the investigators are conducting a randomized controlled trial (RCT) to assess the efficacy of an 8-week virtual chair yoga program to improve stress, psychological symptoms, and caregiver burden. This virtual chair yoga study will engage both older adults with dementia/MCI and caregivers (n=40-60 participants) during COVID-19, which is consistent with the need for decreasing costs and increasing accessibility of novel health interventions during and beyond the pandemic. The investigators will evaluate the effect of this program on stress, loneliness, and mental health related outcomes such as fear of COVID-19, depression, anxiety, and caregiver burden compared to a waitlist control group. There will also be a qualitative component in the form of semi-structured interviews. All quantitative outcomes will be assessed before the program starts and post-intervention and qualitative outcomes will be assessed post-intervention. Participants will be randomly assigned to the treatment group (virtual chair yoga 1 hour per week on Zoom) or the waitlist control group. The investigators hypothesize that after the 8-week yoga program, older adults and caregivers will report lower stress, loneliness, depression, anxiety, fear of COVID-19, and caregiver burden. Results will be available late-2021.

Start: July 2021

Home-delivered Meals for Persons With Dementia: Which Model Delays Nursing Home Placement?

This project is the pilot phase of a pragmatic randomized clinical trial comparing outcomes among older adults with Alzheimer's disease and related dementias (ADRD) receiving home-delivered meals. This pilot will test and validate vital elements and procedures including: 1) enrolling persons with ADRD on Meals on Wheels (MOW) programs' waiting lists to receive one of the two types of meals; 2) recruiting a subsample of participants and caregivers to participate in telephone interviews; 3) extracting and transferring program data to Brown University; 4) linking participant data with Medicare and nursing home assessment data. Persons with ADRD receiving meals and their caregivers will be recruited to pilot interview guides. The interviews will provide important process and mechanistic information about the experiences receiving meals and participants' outcomes.

Start: April 2021

EPIC: An Intervention for Early-stage AD Dyads

EPIC II (Early-Stage Partners in Care) is a research project designed to assist people with early-stage memory loss and their care partners by providing early-stage related education and skill-training sessions designed to reduce stress, enhance well-being, manage challenges, and plan for the future. Researchers will gather feedback from individuals about their experience to continue to improve programs for early-stage memory loss.

Start: December 2017

Escitalopram for Agitation in Alzheimer's Disease

The purpose of this study is to evaluate the safety and efficacy of escitalopram for agitation in Alzheimer's dementia.

Start: January 2018

WeCareAdvisor: A Web-Based Tool to Improve Quality of Life for Military Veterans With Dementia and Their Caregivers

This research will test the WeCareAdvisor tool for family caregivers of military veterans with dementia to help caregivers assess, manage and track behavioral symptoms and their contributing factors (e.g., pain, sleep disturbance), and that provides tailored strategies for in-home, medication-free behavior management. 60 caregiver-person with dementia dyads will be recruited (30 Treatment Group, 30 Wait-List Control Group).

Start: October 2020

Nociception-Level (NOL) for the Assessment of Pain in Patient Unable to Self-Report

In this study we aimed to investigate the performance and effectiveness of NOL and/or NOLedge as a tool for pain assessment in geriatric and critical ill non communicating patients. Our hypothesis was that NOL and the NOLedge may have good correlation with the health-care professional assessment PAINAD, BPS values, even with the use of the drugs affecting autonomic nervous system.

Start: November 2020

Decreasing Agitation in Patients With Dementia Through the Use of Weighted Blankets

Hospitalized patients with dementia and aggression and/or agitation will be given a weighted blanket to see if there are significant reductions in agitated and aggressive behaviors compared to treatment as usual.

Start: April 2018

Rural Dementia Caregiver Project

These caregivers are a vulnerable group due to their physical isolation and well-documented rural disparities in health care access and quality. Many rural dementia caregivers experience serious health consequences due to caregiving responsibilities that can limit their ability to maintain their caregiving role. Thus, there is a pressing need for effective, scalable, and accessible programs to support rural dementia caregivers. Online programs offer a convenient and readily translatable option for program delivery because they can be accessed by caregivers in the home and at the convenience of the user. Building Better Caregivers is an online 6-week, interactive, small-group self-management, social support, and skills-building workshop developed for caregivers of individuals with Alzheimer's disease or related dementia. The investigators will conduct a hybrid effectiveness-implementation randomized controlled trial that will enroll and randomize 640 rural dementia caregivers into two groups: 320 in the intervention (workshop) group and 320 in the attention control group. Caregivers will be recruited throughout the United States. Primary outcomes will be caregiver stress and depression symptoms. The investigators hypothesize that stress scores and depression symptoms will be significantly improved at 12 months in the intervention group versus control group. The investigators will also identify key strengths (facilitators) and weaknesses (barriers) of workshop implementation. The investigators will use the RE-AIM implementation framework and a mixed methods approach to identify implementation characteristics pertinent to both caregivers and rural community organizations. If the Building Better Caregivers workshop is proven to be effective, this research has the potential to open new research horizons, particularly on how to reach and effectively support isolated dementia caregivers in rural areas with an intervention that is scalable, even in low-resourced settings. If the workshop can achieve its goals with rural dementia caregivers, some of those most isolated, it would also be expected to be scalable in other low-resourced settings (e.g., in urban or suburban environments).

Start: June 2020

5-Cog Battery for Detecting Cognitive Impairment and Dementia

Despite the availability of numerous cognitive assessment tools, cognitive impairment related to dementia is frequently under-diagnosed in primary care settings. The investigators have developed a 5-minute cognitive screen (5-Cog) coupled with a decision tree to overcome the technical, cultural and logistic barriers of current cognitive screens to improve dementia care in primary care patients with cognitive concerns.

Start: May 2019

On Site Sensors Monitoring Impacts of Cognitive Decline on ADLs

The purpose of this research is to compare the effectiveness of a continuous monitoring system to assess Activities of Daily Living (ADLs) over time compared to the traditional assessments used by medical professionals as Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD) progresses.

Start: September 2020

ACT for People With Dementia Experiencing Psychological Distress

Dementia is a condition that causes cognitive decline beyond normal ageing. Anxiety and depression are very common in people with dementia, but their needs are often under-recognised and under-served. Acceptance and Commitment Therapy (ACT) can reduce anxiety and depression by increasing psychological flexibility, the ability to pursue a meaningful life, in spite of unpleasant thoughts or feelings. There is much to learn about if and how ACT works for people with dementia, and whether it could be an effective psychological therapy for this population. Three participants with a dementia diagnosis and clinically-significant levels of anxiety and/or depression will be identified by their GP or Memory Assessment Service (MAS) in Nottinghamshire. Participants will attend 12 weekly, 90-minute sessions of ACT with the Principal Investigator (PI), accompanied by their caregiver if they so wish. In session, participants will complete several short questionnaires to measure their anxiety and depression, goals for therapy, psychological flexibility and relationship with the therapist. One week after the final session, an independent researcher will meet with participants and their carers to discuss their opinions of therapy and any changes to their anxiety and/or depression. One and three months after therapy, participants will be sent two short questionnaires to measure their current anxiety and depression. Information gathered from the independent researcher and questionnaires will be used to develop a case record for each participant, which will be looked at by independent psychotherapy experts to see whether ACT was effective. This research is being funded by Health Education England and is expected to last one year in total. Participant duration will last about 7 months. The study will form a Doctoral Thesis at the University of Nottingham and will be submitted to a peer-reviewed journal for distribution.

Start: January 2021

LifeBio Memory Digital Reminiscence Platform

Non-pharmacological interventions and person-centered care strategies are important elements of care for people with Alzheimer's disease and related dementias. Life story work, which uses written and oral life histories to elicit conversation and memories, is an effective intervention for individuals with dementia; however, because of the time-consuming nature of generating useful life story materials, has not been widely implemented in nursing homes and other care environments. LifeBio Inc. will develop an easy-to-use reminiscence therapy platform - LifeBio MemoryTM - with a novel machine-learning-based application that converts speech to text and generates life stories to serve as an interactive tool to cultivate communication between people living with dementia and their family and caregivers.

Start: May 2021

Electronic-Nutrition-Optimizer for Personalized Prevention

This study aims to develop and validate a tool for immediate nutrition assessment and to test its user feasibility in routine clinical practice for health promotion.

Start: June 2021

Persons With Dementia and Their Extended Family Caregivers

Immediate family members provide the vast majority of care for relatives with Alzheimer's disease, but their availability as caregivers is shrinking. Societal trends, such as declining birthrates and rising divorce rates among middle-aged and older adults raise questions about the sustainability of traditional approaches to family care. At the same time, greater longevity and various social movements, legal and policy changes, and social problems have led to a much broader array of family structures. Older adults now have expanded family boundaries beyond the level of the nuclear family. Their lives are embedded and closely linked to their adult grandchildren, siblings, nieces/nephews as well as non-biological kin, including step-kin- any of whom may become their primary caregiver. An examination of the experiences of these extended family caregivers (CG) and the home and community-based services (HCBS) they use and need to assist with their relatives' care, as well as barriers to service use, will inform delivery of HCBS aimed at ameliorating care-related stressors and improving the quality of life of persons with Alzheimer's disease and other dementias. The study aim is to learn about different relational types of extended family members' paths to dementia caregiving, how they manage their care responsibilities, what HCBS and informal support they use to meet the needs of the person with dementia (PwD), and the resultant effects on the PwD and their own well-being. A mixed-methods design will be used to understand the issues faced by the CG and their use of HCBS to care for the PwD. Using an extensive network with organizations in Virginia to identify extended family CG, a telephone interview comprised of open-ended questions, standard items and structured measures, followed by a semi-structured 8-day diary interview of daily experiences with HCBS, will be administered to 240 extended family members who serve as the primary CG of a PwD living in the community. Study findings will advance scientific knowledge about extended family CG and their use of HCBS beyond that which has emerged from the literature focused on nuclear family CG, providing a more elaborated conception of caregiving that acknowledges the transformations occurring in family life today. This expanded understanding will provide new and relevant information for HCBS/programs designed to support family CG.

Start: April 2021

Combining Acupuncture and Acupressure for Community-dwelling Elderly With Dementia

This is an assessor-blinded, randomized controlled trial. A total of 248 community-dwelling elderly people aged ?65 years with a mid-mild to moderate dementia will be recruited from confirmed local 24 nursing and care homes. They will be randomly assigned to routine care, CAT, CAE, and CAT+CAE with n = 62 subjects each group. Subjects assigned to CAT, CAE, and CAT+CAE will respectively receive 2 sessions of CAT, 3 sessions of CAE, and a combination of both per week for 12 weeks. The primary outcome is baseline-to-endpoint change in score of the Montreal Cognitive Assessment (MoCA). Secondary outcomes include various domains of MoCA, functional independence, psychological well-being; sleep quality, and level of pain. A generalized linear mixed-effect model will be used to compare outcomes over time among the four groups.

Start: May 2021

Effect of Soundscape on People With Dementia.

In the last few decades, insights into the impact of the sonic environment on persons have grown to include not only the adverse effects of extensive mechanical noise but also the beneficial effects of a well-designed sonic environment. People with dementia, however, perceive and understand the sonic environment differently. The most obvious difference is that the meanings they may give to the sounds they notice due to changing mental associations. However, also at an earlier perceptual stage, attention focusing and gating may be affected, reducing their ability to analyze a complex auditory scene. Behaviour associated with the appraisal of the sound environment may change with the emergence of dementia. The objective of this study is to determine the effect size of a carefully tuned personalized sonic environment (delivered via AcustiCare) on agitation and distress (NPI and PAS), night sleep and stress (Via wristband) and on quality of life (QUALIDEM) in a population of older adults with dementia and behavioural symptoms.

Start: April 2021

Decreased Empathy and Emotion Recognition in Patients With Neurodegenerative Disease

This study evaluates an educational brochure tailored to caregivers of people with Alzheimer's disease, Parkinson's disease dementia, Lewy body disease, frontotemporal dementia, and vascular disease dementia. The goal of the brochure is educating caregivers about the decreased ability to detect emotion and decreased empathy that can be seen in dementia, increasing caregiver competence in providing care, and teaching caregivers ways to manage over time that lessens burden and improves quality of life.

Start: July 2019

In-Home Technology for Caregivers of People With Dementia and Mild Cognitive Impairment

This study aims to develop and evaluate new in-home supportive technology that is designed to alleviate anxiety, burden, and loneliness in spousal and familial caregivers of individuals with Alzheimer's disease, other dementias, or mild cognitive impairment.

Start: March 2020

Evaluation of the Impact of Cochlear Implants on Cognition in Older Adults

The subjects will be age 65 years and older, with no upper limit of age range with hearing loss that are candidates for standard-of-care cochlear implant. Cognitive tests will be administered preoperative, and postoperative at 6 and 12 month intervals.

Start: November 2015

The Residential Care Transition Module

Emerging research on family caregiving and institutionalization has emphasized that families do not disengage from care responsibilities following a relative's admission to residential long-term care settings. The Residential Care Transition Module (RCTM) provides 6 formal sessions of consultation (one-to-one and family sessions) over a 4-month period to those family caregivers who have admitted a cognitively impaired relative to a residential long-term care setting (nursing home, assisted living memory care unit). The proposed mixed method, randomized controlled trial will determine whether and how the RCTM decreases family caregivers' emotional and psychological distress, placement-related strain, and increases relative's transitions back to the community. The RCTM will fill an important clinical and research gap by evaluating a psychosocial intervention designed for families following RLTC placement to determine whether and how this approach can help families better navigate the residential care transitions of relatives with Alzheimer's disease or a related dementia.

Start: December 2016