Innovations in Dementia Empowerment and Action (IDEA)

September 13, 2023 updated by: Karen Fredriksen Goldsen, University of Washington

Aging With Pride: Innovations in Dementia Empowerment and Action

The lack of efficacious research-based interventions for such vulnerable older adults with Alzheimer's disease and related dementias (AD/RD) and their caregivers (CGs) is a significant public health problem. Caregiving of sexual/gender minority older adults with AD/RD is of concern due to social stigma, marginalization, and isolation, which may be barriers to sustaining caregiving. It is necessary and timely to translate evidence-based culturally adaptable interventions for this underserved and stigmatized population. Reducing Disability in Alzheimer's Disease (RDAD) has been evaluated in a randomized controlled trial and has shown to successfully train community-dwelling CR (care receiver)-CG dyads to increase the physical activity and functioning of individuals with AD/RD and their CGs and to teach CGs techniques for managing behavioral symptoms of CRs. RDAD consequently decreases stress of CGs, delays institutionalization of CRs, and increases health related quality of life (HRQOL) of CRs and CGs. Thus, this study will evaluate the effect of the standard RDAD among lesbian, gay, bisexual, and transgender (LGBT) CRs with AD/RD and their CGs, and this study will test a personalized intervention tailored to better respond to distinct risks experienced by CGs and LGBT CRs with AD/RD, addressing unique sexual/gender minority CG risk factors (e.g., identity management, stigma-related adverse or traumatic life events, and lack of social support).

Study Overview

Detailed Description

We will address the following aims:

Aim 1. Test the translation and enhancement of intervention designed to increase physical activities of older adult care receivers (CRs) with AD/RD and their CGs. Aim 2. Evaluate the short- and long-term effect of the standard and personalized intervention on primary (physical activity and functioning; perceived stress for CGs; independence/residential status (institutionalization) for CRs) and secondary outcomes (HRQOL; depressive symptomatology; behavioral disturbances for CRs). Aim 3. Test the moderating roles of CR-CG characteristics, including type of CR-CG relationship, sex, and severity of CR AD/RD, on the treatment effect of the standard and personalized intervention.

Study Type

Interventional

Enrollment (Actual)

322

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Washington
      • Seattle, Washington, United States, 98105
        • University of Washington

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion criteria for care receiver

  • Age at enrollment is 50 years of age or older
  • Have dementia, (e.g., Alzheimer's disease, MCI, Vascular dementia, Parkinson's disease, Lewy Body dementia) or memory loss significant enough to affect daily activities
  • Living in the community, not in a care facility.
  • Living in the U.S.
  • Either the care receiver or care giver must self-identify as LGBT (or sexual or gender non-binary or same sex sexual behavior)

Inclusion criteria for care giver

  • Provide care to the care recipient with dementia.
  • Willing to spend 30 minutes daily for study activities (or coordinate for someone to.)
  • Unpaid
  • Live in the community, not in a care facility
  • Living in the U.S.

Neither care receiver nor caregiver:

  • Has known terminal illness (with death anticipated within the next 12 months)
  • Was hospitalized for a psychiatric disorder in the 12 months prior to baseline
  • Is currently suicidal or having major hallucinations or delusions
  • Plans to move to long term care setting within 6 months of enrollment.
  • Has any physical limitations/chronic conditions preventing participation in an exercise program.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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
Active Comparator: Standard intervention

Reducing Disabilities in Alzheimer's Disease (RDAD):

9 60-minute virtual sessions for 6 weeks and 4 15-minute follow-up phone sessions for 4 months

The RDAD intervention includes behavioral management training for caregiver and activities and exercise training for caregiver and care receiver.
Other Names:
  • Standard RDAD
Experimental: Personalized intervention

Innovations in Dementia Empowerment and Action (IDEA):

9 60-minute virtual sessions for 6 weeks and 4 15-minute follow-up phone sessions for 4 months

The IDEA intervention has the same exposure to treatment as the RDAD intervention. The behavioral component of the treatment manual is adapted to incorporate 3 risk factors that are empirically known to affect midlife and older LGBT populations.These include: 1) identity management; 2) stigma-related adverse/traumatic life events; and 3) lack of social support. All other aspects of the treatment are preserved.
Other Names:
  • Personalized RDAD

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Perceived Stress (PSS) of Caregiver
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
14-item self-report measure designed to measure nonspecific, appraised stress during the past month
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Physical Activity of Care Recipient
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Days exercise >= 30 min in the past week
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Physical Activity of Caregiver
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Days exercise >= 30 min in the past week
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Physical Functioning of Care Recipient
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Medical outcomes study short form (MOS SF-36)
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Physical Functioning of Caregiver
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Medical outcomes study short form (MOS SF-36)
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Quality of Life (QOL-AD) of Care Recipient
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
QOL-AD measure
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Rate of Care-Recipient Behavioral Disturbances
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Revised Memory and Behavior Problem Checklist (RMBPC) assess presence and frequency of memory, depressive, disruptive behavior and caregiver response
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
Change in Depressive Symptomatology of Caregiver
Time Frame: Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months
CESD-10
Baseline, 6 weeks, 13 weeks, 30 weeks, 13 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Karen Fredriksen-Goldsen, PhD, University of Washington

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 5, 2018

Primary Completion (Actual)

May 16, 2023

Study Completion (Actual)

May 16, 2023

Study Registration Dates

First Submitted

April 6, 2018

First Submitted That Met QC Criteria

May 25, 2018

First Posted (Actual)

June 8, 2018

Study Record Updates

Last Update Posted (Actual)

September 15, 2023

Last Update Submitted That Met QC Criteria

September 13, 2023

Last Verified

September 1, 2023

More Information

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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