- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01273272
Cognitive-Behavioral Treatment for Mild Alzheimer's Patients and Their Caregivers (CBTAC)
Cognitive-Behavioral Treatment for Patients With Mild Alzheimer's Dementia: A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Mild Alzheimer's dementia (AD) cases are with 15 millions worldwide the largest fraction of all AD cases. Most patients are cared for by their family at home. Neuropsychiatric symptoms are very common in AD, even as early as in mild AD: About 90% of all mild AD cases experience neuropsychiatric symptoms, most frequently depression, anxiety, and irritability. These symptoms are associated with greater morbidity, reduced quality of life for the patient, increased burden and depression for the caregiver, higher costs of care, and nursing home placement. Thus, interventions aimed at treating these symptoms could have a tremendous effect on pa-tients, caregivers, and society.
This study is a randomized, controlled trial (RCT) evaluating a comprehensive CBT-based, multi-component treatment programme consisting of eight modules (diagnosis and goal-setting; psycho-education; engagement in pleasant activities; cognitive restructuring; life review; training caregiver in behavior management techniques; interventions for the caregiver; couples counseling) and 20 sessions.
This trial aims at significantly reducing depressive and other neuropsychiatric symptoms in the AD patients, and secondary in reducing burden and depressive symptoms of the caregivers. Patients with AD alone or mixed AD and vascular dementia that are in the mild stage and suffer under any neuropsychiatric symptom will be included. The patients and their caregiver will be randomized to either the CBT-based intervention or to the control condition that receives treatment as usual (TAU).
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Zurich, Switzerland, 8032
- Psychiatric University Hospital, Clinic for Geriatric Medicine
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients have to meet NINCDS-ADRDA criteria for probable or possible AD (McKhann et al., 1984). Mixed Alzheimer and Vascular dementia cases will also be included.
- Only AD cases with a mild dementia severity will be included, determined by the Clinical Dementia Rating (CDR) scale (i.e. scores of 0.5 or 1, Morris, 1993) and by the Mini Mental State Examination (MMSE) (i.e. scores of 20 or more, Folstein, Folstein, & McHugh, 1975).
- The patient must suffer under any non-cognitive symptom that motivates him to accept psy-chotherapeutic help.
- A caregiver must be available to take part in most of the therapy sessions.
Exclusion Criteria:
- concomitant alcohol or drug addiction and a history of a malignant disease, severe organ failure, metabolic or hematologic disorders, neurosurgery or neurological condition such as Parkinson's disease, epilepsy, postencephalitic and postconcussional syndrome
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cognitive Behavioral Therapy (CBT)
Comprehensive, CBT-based, multi-component treatment.
Comprehensive CBT intervention in addition to standard treatment
|
It includes eight modules: diagnosis and goal setting; psychoeducation; engagement in pleasant activities; cognitive restructuring; live review; training caregiver in behavior man-agement techniques; interventions for the caregiver; and couples counselling.
It consists of 20 weekly sessions (plus appr.
5 single session with caregiver).
Other Names:
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Active Comparator: Treatment as usual (TAU)
Standard Treatment (medical and psychosocial)
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Each patient/caregiver must receive at least three out of six interventions: (1) psychoeducation on dementia and treatment of dementia (oral and written); (2) appropriate medical treatment; (3) social counseling by specialized staff; (4) memory training in group setting; (5) self-help group for the patient; (6) self-help group for the caregiver.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change from baseline in Geriatric Depression Scale (GDS)
Time Frame: Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change from baseline in Neuropsychiatric Inventory (NPI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Change from baseline in Bayer-Activities of Daily Living (B-ADL)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Change from baseline in Stress Coping Inventory (SCI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Change from baseline in Apathy Evaluation Scale (AES)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Caregiver: Change from baseline in Center for Epidemiologic Studies Depression Scale (CES-D)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Trait scale of the State Trait Anxiety Inventory (STAI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Anger-in and anger-out scales of the State Trait Anger Expression Inventory (STAXI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Short-Form Health Survey (SF-12)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Zarit Burden Interview (ZBI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Stress Coping Inventory (SCI)
Time Frame: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Simon Forstmeier, Ph.D., University of Zurich
- Study Chair: Andreas Maercker, M.D.,Ph.D., University of Zurich
- Study Chair: Egemen Savaskan, M.D., Psychiatric University Hospital, Zurich
- Study Chair: Tanja Roth, Ph.D., Psychiatric University Hospital, Zurich
Publications and helpful links
General Publications
- Forstmeier S, Maercker A. Problems of aging. Psychotherapy in older age [German]. Göttingen, Germany: Hogrefe. 2008.
- Forstmeier S, Maercker A. Psychotherapie im Alter. Psychotherapeutenjournal 4: 340-352, 2007
- Forstmeier S, Maercker A, Savaskan E, Roth T. Cognitive behavioural treatment for mild Alzheimer's patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials. 2015 Nov 17;16:526. doi: 10.1186/s13063-015-1043-0.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 10-130034/1a
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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