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Promoting Activity, Independence and Stability in Early Dementia and Mild Cognitive Impairment (PrAISED2)

20. august 2019 opdateret af: Nottingham University Hospitals NHS Trust
A clinical trial to test the clinical and cost-effectiveness of a therapy intervention designed to promote activity and independence and reduce falls, amongst people with early dementia or mild cognitive impairment

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Background and study aims People with memory problems can struggle with everyday activities and may stop doing things they want to do. They are more prone to accidents and have a higher risk of falling. Occupational therapists can advise how to do daily activities more easily and safely. Physiotherapists can teach exercises which increase activity and improve balance, and may help maintain memory. There is little research on how to make these interventions work for with people with memory problems. The aim of this study is to compare an activity and exercise programme developed for people with memory problems to standard falls prevention assessment and advice.

Who can participate? Patients aged 65 or over with early dementia or memory problems, recruited from memory clinics or the 'Join Dementia Research' register

What does the study involve? Participants are randomly allocated to either the control group or the intervention group. The control group receive standard brief falls assessment and advice, and up to two further visits if required. The intervention group receive an assessment, tailored strength and balance exercise programme, activity analysis and risk enablement advice, and assessment for environmental hazards. The intervention is delivered over 1 year in participants' own homes, and is tailored to individual interests, abilities and need for supervision. Participants are encouraged to exercise by themselves or with family members between visits, and once the programme ends. Researchers visit at the start of the study and after 12 months to measure ability in activities of daily living, activity, quality of life, memory and health service use. Participants complete monthly falls diaries over 15 months. The researchers conduct interviews and video record some therapy sessions to help understand how the programme works in practice.

What are the possible benefits and risks of participating? Some participants may benefit from taking part in the intervention, as exercise is generally known to be beneficial to health and well-being, including benefits to heart, blood pressure, diabetes, joints, mood and daily life. These participants may find that they are better able to do their daily activities. All participants and their relatives may enjoy having the researchers coming to visit them in their house. Some people appreciate having the opportunity to contribute to the well-being of others through research.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

368

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Det Forenede Kongerige
    • Derbyshire
      • Derby, Derbyshire, Det Forenede Kongerige, DE22 3LZ
    • Lincolnshire
      • Lincoln, Lincolnshire, Det Forenede Kongerige, NG34 8GG
    • Notts
      • Nottingham, Notts, Det Forenede Kongerige, NG3 6AA
    • Somerset
      • Bath, Somerset, Det Forenede Kongerige, BA1 3NG
        • Rekruttering
        • RICE - Research Institute for the Care of Older People
        • Kontakt:
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

65 år og ældre (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Age 65 or over (no maximum)
  2. Diagnosis of MCI or dementia (of any subtype, except Dementia with Lewy Bodies i.e. Parkinson's Disease Dementia)
  3. Have a carer or friend who knows the participant well (at least one hour a week contact over the phone, internet, or in person), and is willing and able to act as an informant
  4. Able to walk without human help
  5. Able to communicate in English
  6. Able to see, hear and have dexterity sufficiently to perform neuropsychological tests
  7. Have capacity to give consent to participate, and consenting to do so

Exclusion Criteria:

  1. Co-morbidity preventing participation (e.g. severe breathlessness, pain, psychosis, Parkinson's, Dementia with Lewy Bodies, or other severe neurological disease)
  2. Unavailable over the next year (e.g. plans to relocate or go on a long holiday, or has a life expectancy of less than a year)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Control
The control group will receive standard brief falls assessment and advice.
Aktiv komparator: Intervention
Therapy intervention.
Adfærdsmæssigt: Intervention
Assessment, tailored strength and balance exercise programme, activity analysis and risk enablement advice, and assessment for environmental hazards. Tailored adherence support and supervision.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Disability Assessment in Dementia (DAD)
Tidsramme: 12 months

Primary outcomes will be disability in Activities of Daily Living (Disability Assessment in Dementia, DAD) measured 12 months after randomisation. This is as recommended in a recent NIHR systematic review [Webster 2017].

scale range is 0% to 100%. Where 0% = minimal functional ability and 100% maximal functional ability. Higher scores represent less disability in ADL and lower scores indicate more dysfunction. There are no subscales.

"The total score is obtained by adding the rating for each question and converting this total score out of 100. The items rated as N/A are not considered for the total score. For example:

A score of 33 on 40 (maximum score) converted out of 100 = 83% A score of 33 on 38 (max. score with 2 N/A) converted out of 100 = 87%

This will result in a final score, a percentage which provides an appreciation of global function in ADL. Higher scores represent less disability in ADL while lower scores indicate more dysfunction."
12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Nottingham Extended ADL Scale
Tidsramme: 12 months
Self-reported Activities of Daily Living (ADL) using the Nottingham Extended ADL Scale [Nouri and Lincoln 1980].
12 months
Falls Rate
Tidsramme: 12 months
Falls rate in months four-15 from randomisation (defined as 'unintentionally coming to rest on the ground or at a lower level, however caused', and ascertained by monthly diary)
12 months
Quality of Life
Tidsramme: 12 months
Quality of life (EQ5D3L and EQ5D5L proxy [EuroQol Group 1990]; DemQol and DemQol proxy, including Demqol-u weights [Smith 2005; Mulhern 2013])
12 months
Mood or 'Affect'
Tidsramme: 12 months
Mood or 'Affect' - Hospital Anxiety and Depression Scale (HADS [Zigmond and Snaith 1983]; Apathy Evaluation Scale - AES [Marin, Biedrzycki and Firinciogullari 1991])
12 months
Physical activity
Tidsramme: 12 months
Longitudinal Aging Study Amsterdam (LASA) physical activity questionnaire [Stel 2004], pedometers
12 months
Cognition
Tidsramme: 12 months
three scales from CANTAB [Cambridge Cognition, 2015]; Montreal Cognitive Assessment - MoCA [Nasreddine 2005], verbal fluency (from MoCA)
12 months
Time to first fall
Tidsramme: 12 months
Time to first fall (from diary)
12 months
Rate of fractures and injurious falls
Tidsramme: 12 months
Rate of fractures and injurious falls (from diary)
12 months
Rate of hospital and care home admissions, and days spent in hospital
Tidsramme: 12 months
Rate of hospital and care home admissions, and days spent in hospital (from diary, hospital administrative records)
12 months
Carer strain
Tidsramme: 12 months
Carer strain (Carergiver Strain Index [Robinson 1983]).
12 months
Carer health-related quality of life
Tidsramme: 12 months
Carer health-related quality of life (EQ5D-5L [EuroQol Group 1990])
12 months
Personality
Tidsramme: 12 months
Personality (Big Five Personality Inventory- short [BFI-10, Rammstedt and John 2007])
12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Nottingham University Hospitals NHS Trust

Samarbejdspartnere

National Institute for Health Research, United Kingdom

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2018

Primær færdiggørelse (Forventet)

31. marts 2021

Studieafslutning (Forventet)

13. marts 2022

Datoer for studieregistrering

Først indsendt

21. maj 2019

Først indsendt, der opfyldte QC-kriterier

20. august 2019

Først opslået (Faktiske)

22. august 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. august 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

20. august 2019

Sidst verificeret

1. august 2019

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 17HC006

Plan for individuelle deltagerdata (IPD)

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